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Granular acute lymphoblastic leukemia.

P Stein, S Peiper, D Butler

    American Journal of Clinical Pathology
    |April 1, 1983
    PubMed
    Summary
    This summary is machine-generated.

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    This study details acute lymphoblastic leukemia (ALL) cases with granules in lymphoblasts, a rare presentation. Recognizing this specific ALL subtype is crucial to prevent misdiagnosis as acute non-lymphocytic leukemia.

    Area of Science:

    • Hematology
    • Oncology
    • Cytopathology

    Background:

    • Granules in blasts typically indicate acute myeloblastic leukemia.
    • Rare instances of acute lymphoblastic leukemia (ALL) with granular lymphoblasts have been reported but lacked detailed characterization.

    Purpose of the Study:

    • To investigate the cytologic, immunologic, and cytogenetic features of acute lymphoblastic leukemia (ALL) with azurophilic cytoplasmic granules.
    • To differentiate this morphologic subtype of ALL from acute non-lymphocytic leukemia.

    Main Methods:

    • Detailed cytologic examination of blasts.
    • Immunophenotypic analysis using flow cytometry.
    • Cytogenetic studies including karyotyping.
    • Electron microscopy in one case.

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  • Staining for peroxidase, chloroacetate esterase, PAS, acid phosphatase, and non-specific esterases.

    • Main Results:

    • Five cases of ALL with distinct cytoplasmic azurophilic granules in lymphoblasts were identified.
    • Granules were negative for peroxidase and chloroacetate esterase but positive for PAS, acid phosphatase, and non-specific esterases.
    • Immunophenotyping confirmed a common ALL phenotype.
    • Cytogenetic abnormalities were present in all cases.
    • Electron microscopy revealed membrane-bound inclusions in lymphoblasts.

    Conclusions:

    • This study characterizes a specific morphologic subtype of ALL presenting with granular lymphoblasts.
    • Accurate diagnosis requires recognition of these features to avoid misclassification as acute non-lymphocytic leukemia.
    • Further research into the clinical implications of this ALL subtype is warranted.