Acute promyelocytic leukemia, hypogranular variant, with uncharacteristic staining with chloroacetate esterase.

Abstract

A diagnosis of the hypogranular variant of acute promyelocytic leukemia (APLv) may be difficult to establish based on cytomorphology alone. However, the great majority of cases have a classical immunophenotype by flow cytometric immunophenotyping (FCI) (CD13+, CD33+, dim CD64+, HLA-DR-, and CD34-) and a classical enzyme cytochemical (EC) staining pattern. [intensely staining with myeloperoxidase, Sudan Black B, and chloroacetate esterase (CAE) and negative with alpha'-naphthyl acetate and butyrate esterases]. Although the immunophenotype of APLv by FCI has varied in the literature (HLA-DR +/- and CD34 +/-), the EC staining pattern has remained constant. We report a case of APLv with characteristic cytomorphology, compatible FCI data (CD13+, CD33+, dim CD64+, HLA-DR +/-, and CD34-), chromosomal detection of t(15; 17), and molecular detection of the PML/RAR alpha fusion gene; however, staining of the leukemic cells with CAE was quite uncharacteristic. We describe our findings.

• Authors: C H Dunphy, J M Polski, G Johns, H L Evans, L J Gardner
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 42 Issue 1-2 Pg. 215-9 (Jun 2001) ISSN: 1042-8194 [Print] United States
• PMID: 11699210 (Publication Type: Case Reports, Journal Article)

Chemical References

• Carboxylic Ester Hydrolases
• chloroacetate esterase

Topics

• Aged
• Carboxylic Ester Hydrolases (analysis)
• Chromosomes, Human, Pair 15
• Chromosomes, Human, Pair 17
• Cytogenetic Analysis
• Histocytochemistry
• Humans
• Immunophenotyping
• Leukemia, Promyelocytic, Acute (diagnosis, enzymology, pathology)
• Male
• Staining and Labeling
• Translocation, Genetic