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A Rare Case Study of Granular Acute Lymphoblastic Leukemia Combined with Pleural Infiltration
Insights
Granular acute lymphoblastic leukemia is a rare subtype that can be mistaken for other blood cancers. Comprehensive diagnostic tests are crucial for accurate identification and treatment.
Area of Science:
- Hematology
- Oncology
- Pathology
Background:
- Acute B-lymphoblastic leukemia (B-ALL) typically presents with minimal to moderate cytoplasm and few granules.
- A rare subtype, granular acute lymphoblastic leukemia, is characterized by abundant coarse, purplish-red cytoplasmic granules.
Observation:
- A patient presented with blasts exhibiting numerous coarse, purplish-red granules.
- Morphological features mimicked acute myeloid leukemia and basophilic granulocytic leukemia.
Findings:
- Cytochemical and immunophenotypic analyses confirmed the diagnosis of granular acute lymphoblastic leukemia.
- Pleural infiltration was noted in this case.
Implications:
- Accurate diagnosis of granular acute lymphoblastic leukemia is critical due to its rarity and potential for misdiagnosis.
- Comprehensive diagnostic workups, including cytochemistry and immunophenotyping, are essential.
- This case provides valuable insights for understanding this rare leukemia subtype.
Background:
Acute B-lymphoblastic leukemia (B-ALL) is a common hematologic malignancy characterized by blasts with a variable amount of cytoplasm, typically ranging from minimal to moderate, and containing few cytoplasmic granules. However, granular acute lymphoblastic leukemia, as a rare subtype, is distinguished by the presence of abundant coarse, purplishred granules within the cytoplasm of the blasts, which can be confused with other diseases in clinical diagnosis.
Methods:
The patient was examined using bone marrow morphological analysis, flow cytometry, genetic screening, and chromosome karyotype analysis.
Results:
The case presented with a high number of coarse, purplishred granules in the cytoplasm of the blasts, which morphologically resembles acute myeloid leukemia and basophilic granulocytic leukemia. Through cytochemical and immunophenotypic analyses, we ultimately diagnosed the case as granular acute lymphoblastic leukemia with pleural infiltration.
Conclusions:
Granular acute lymphoblastic leukemia, as a rare subtype, requires particular attention in clinical diagnosis. Cases with similar morphological features should undergo comprehensive diagnostic workups, including cytochemical and immunophenotypic analyses, to avoid misdiagnosis. This case report provides an important reference for further understanding of granular acute lymphoblastic leukemia.
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