The Hand Mirror Image: Which is the Lineage in the End?
Abstract
According to the World Health Organization (WHO) 2016 classification, acute promyelocytic leukemia (APL) is placed in the category of AML with recurrent cytogenetic abnormalities. Cytogenetic confirmation of reciprocal translocation t(15:17) is essential criteria for diagnosis of this entity. However, these tests may have a significant time delay and it is usually the characteristic morphology of the abnormal promyelocytes which helps to pick up the diagnosis early and alert the clinician to initiate treatment promptly. The two variants commonly described are the hypergranular and the variant (M3v) forms, but knowledge of other rarer morphological variants of APL becomes crucial in certain situations for the hematopathologist. To highlight this phenomenon, we describe a case report of a 9-year-old female who presented with a hand mirror morphology of the abnormal promyelocytes.References
Sandes AF, Rizzatti EG. Magic mirror in my hand, which is the lineage in the end? A case of acute leukemia with hand mirror cells. Blood 2014; 24 :317.
Sun T, Weiss R. Hand mirror variant of microgranular acute promyelocytic leukemia. Leukemia 1991; 5:266-269.
Sim J, E Ma. Acute Promyelocytic leukemia or not? Hong Kong Association of Blood transfusion and Hematology . June 2004.
Swerdlow SH, Campo E, Harris NL et al. WHO Classification of Tumours of Hematopoietic and Lymphoid Tissues. Lyon: IARC; 2017 Revised 4th edition 134-135.
Sainty D , Liso V, Cantù-Rajnoldi A, Head D et al. A new morphologic classification system for acute promyelocytic leukemia distinguishes cases with underlyingPLZF/RARA gene rearrangements. Blood 2000, 96 (4): 1287–1296
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).
