Biomaterial Database

Hand-mirror variant of microgranular acute promyelocytic leukemia. 1991

T Sun, and R Weiss

Department of Laboratories, North Shore University Hospital-Cornell University Medical College, Manhasset, New York 11030.

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.

UI	MeSH Term	Description	Entries
D008214	Lymphocytes	White blood cells formed in the body's lymphoid tissue. The nucleus is round or ovoid with coarse, irregularly clumped chromatin while the cytoplasm is typically pale blue with azurophilic (if any) granules. Most lymphocytes can be classified as either T or B (with subpopulations of each), or NATURAL KILLER CELLS.	Lymphoid Cells,Cell, Lymphoid,Cells, Lymphoid,Lymphocyte,Lymphoid Cell
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D001853	Bone Marrow	The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells.	Marrow,Red Marrow,Yellow Marrow,Marrow, Bone,Marrow, Red,Marrow, Yellow
D006651	Histocytochemistry	Study of intracellular distribution of chemicals, reaction sites, enzymes, etc., by means of staining reactions, radioactive isotope uptake, selective metal distribution in electron microscopy, or other methods.	Cytochemistry
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015473	Leukemia, Promyelocytic, Acute	An acute myeloid leukemia in which abnormal PROMYELOCYTES predominate. It is frequently associated with DISSEMINATED INTRAVASCULAR COAGULATION.	Leukemia, Myeloid, Acute, M3,Leukemia, Progranulocytic,Myeloid Leukemia, Acute, M3,Progranulocytic Leukemia,Promyelocytic Leukemia, Acute,AML M3,Acute Promyelocytic Leukemia,Leukemia, Acute Promyelocytic,M3 ANLL,ANLL, M3,Acute Promyelocytic Leukemias