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Mixed Phenotypic Acute Leukemia Presenting as Mediastinal Mass-2 Cases
Rig Vardhan1, Jyoti Kotwal1, Prosenjit Ganguli1
1Department of Pathology, Army Hospital (Referral & Research), Delhi, India.
Mixed phenotype acute leukemia (MPAL) is a rare leukemia subtype. Misdiagnosis as lymphoma can occur, highlighting the need for precise diagnostic criteria and tailored treatments for better patient outcomes.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Mixed phenotype acute leukemia (MPAL) represents a rare and challenging subtype of acute leukemia, often difficult to classify as purely myeloid or lymphoid.
- The 2008 World Health Organization classification provides diagnostic standards, emphasizing myeloperoxidase, cytoplasmic CD3, and CD19 markers.
Observation:
- This study presents two cases of MPAL initially suspected as T-cell lymphoma/leukemia due to mediastinal masses.
- One patient received lymphoma treatment based on initial histopathology diagnosis.
Findings:
- These cases illustrate that MPAL can be misdiagnosed as lymphoma on histopathology.
- Accurate diagnosis is crucial as MPAL requires distinct treatment protocols and follow-up strategies.
Implications:
- Increased awareness of MPAL presentation is essential for accurate diagnosis, especially in cases with mediastinal involvement.
- Timely and correct diagnosis can lead to appropriate treatment, potentially improving the poor prognosis associated with MPAL.
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