Sun T, Weiss R
Department of Laboratories, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030.
Leukemia. 1991 Mar;5(3):266-9.
We report a case of microgranular acute promyelocytic leukemia (APL, M3 V) presenting with the typical features of disseminated intravascular coagulopathy and cells with irregular, folded, or bilobed nuclei with occasional intracytoplasmic multiple Auer rods in the peripheral blood. A cytogenetic study of the bone marrow and blood showed translocation between chromosomes 15 and 17, characteristic of APL. The flow cytometric study also confirmed this diagnosis. The unusual feature in this case is the existence of 80% hand-mirror cells, which also contain multiple Auer rods, in the bone marrow. The hand-mirror variant of acute leukemia has been frequently encountered in acute lymphoblastic leukemia, but documented in only six cases of acute myelogenous leukemia, including the FAB groups of M1, M2, M4, and M5. This patient is, to our knowledge, the first reported case of a hand-mirror variant in microgranular APL. The mechanism of hand-mirror cell formation and its prognostic implication are discussed.
我们报告一例微颗粒型急性早幼粒细胞白血病（APL，M3 V），其表现出弥散性血管内凝血的典型特征，外周血中可见细胞核不规则、折叠或分叶，偶尔伴有胞质内多个Auer小体的细胞。对骨髓和血液进行的细胞遗传学研究显示15号和17号染色体之间发生易位，这是APL的特征。流式细胞术研究也证实了这一诊断。该病例的不寻常特征是骨髓中存在80%的手镜样细胞，这些细胞也含有多个Auer小体。急性白血病的手镜样变异型在急性淋巴细胞白血病中经常出现，但仅在6例急性髓细胞白血病中有所记载，包括FAB分型中的M1、M2、M4和M5。据我们所知，该患者是微颗粒型APL中首例报告的手镜样变异型病例。本文讨论了手镜样细胞形成的机制及其预后意义。
