Page 116 - Haematologica Atlas of Hematologic Cytology

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EF Figure 4 cute promyelocy c c c c c c c leu emia with PML-RARA hypergranular type (A) Bone marrow smear Most promye- locytes show numerous coarse red-purple or blue granules granules obscuring the the the nuclei Auer rods are are not not visible There are are no no no mature basophils (B) Bone marrow smear from another case with basophilic granules granules Note the the the irregular bilobed folded nuclei (C) Leukemic promyelocytes are strongly reac ve for peroxidase (le ) ) ) ) ) and chloro-acetate esterase (ri ght) (D) The basophilic basophilic granules granules stain metachroma metachroma cally with toluidine toluidine blue blue Among hypergranular cases of acute promyelocy promyelocy c c c c c c c c c c c c c c c c c c leukemia leukemia a a a a a a a a a a a a a a a a a a a a a a low propor on on are characterized by basophilic basophilic granules granules metachroma metachroma c c c c c c c c c c c c c c c c c c for toluidine toluidine blue blue Immunophenotypic and and cytogene c c c c c c c c c c c c c c c c ndings seem not not to to to di di di di di er er er er from those of other acute promyelocy promyelocy c c c c c c c c c c c c c c c c leukemia leukemia cases but bleeding is is more severe with with extensive disseminated intravascular coagula on (DIC) and and and an an an an an an o o o o o o o o o o o o o o o o o o o o en en en en en fulminant course ( ( and and F) In acute promyelocy c c c c c c c c c c c c c leukemia during treatment with with with all-transre noic acid leukemic promye- locytes undergo matura on on on on with with the appearance of of abnormal neutrophils exhibi ng ng ng marked altera ons of of nuclear segmenta on on on o o o o o o o en en containing Auer rods 103