Cantin G, Bernier V, Jacob S, Lyonnais J
Centre d'Hématologie et d'Immunologie Clinique, Hôpital du Saint-Sacrement, Laval, Québec, Canada.
Nouv Rev Fr Hematol (1978). 1989;31(1):23-6.
A case of microgranular acute promyelocytic leukemia (APL), M-3 variant, is reported in a boy aged 5 years. The disease, which was rapidly fatal, presented with acute disseminated intravascular coagulation (DIC) and leukocytosis. Different cytomorphologic subtypes of promyelocytes were identified on the basis of cytoplasmic granular patterns: the microgranular type with barely visible cytoplasmic granulations and deeply basophilic cytoplasm and the more characteristic type with large promyelocytes containing azurophil granules. We observed a ratio of large promyelocytes to microgranular promyelocytes of 1:1.2 in the marrow and 1:4 in the peripheral blood. To explain this discrepancy, we hypothesize that the microgranular promyelocytes may be more deformable than the typical promyelocyte and that this intrinsic cellular characteristic may promote marrow egress and increase the likelihood of hyperleukocytosis in the M-3 variant.
报告了一例5岁男孩的微颗粒型急性早幼粒细胞白血病（APL），M-3变异型。该疾病进展迅速，最终导致死亡，表现为急性弥散性血管内凝血（DIC）和白细胞增多。根据细胞质颗粒模式确定了早幼粒细胞的不同细胞形态学亚型：微颗粒型，细胞质颗粒几乎不可见，细胞质呈深嗜碱性；以及更具特征性的类型，含有嗜天青颗粒的大型早幼粒细胞。我们观察到骨髓中大型早幼粒细胞与微颗粒型早幼粒细胞的比例为1:1.2，外周血中为1:4。为了解释这种差异，我们推测微颗粒型早幼粒细胞可能比典型早幼粒细胞更具可变形性，并且这种内在细胞特征可能促进骨髓逸出并增加M-3变异型中白细胞增多的可能性。
