Korean J Lab Med.  2011 Apr;31(2):86-90. 10.3343/kjlm.2011.31.2.86.

A Rare Case of Microgranular Acute Promyelocytic Leukemia Associated with ider(17)(q10)t(15;17) in an Old-age Patient

• Kim MJ
• Cho SY
• Lim G
• Yoon HS
• Lee HJ
• Suh JT
• Lee J
• Lee WI
• Cho KS
• Park TS

• KMID: 1094345
• DOI: http://doi.org/10.3343/kjlm.2011.31.2.86

Abstract

We present a rare case of microgranular variant acute promyelocytic leukemia (APL) associated with ider(17)(q10)t(15;17)(q22;q12) of an old-age patient. The initial chromosome study showed a 46,XX,del(6)(?q21q25),der(15)t(15;17)(q22;q12),ider(17)(q10)t(15;17)[10]/47,sl,+ider(17)(q10)t(15;17)[3]/46,XX[16]. FISH signals from a dual color dual fusion translocation PML-RARA probe were consistent with the results of conventional cytogenetics. Because of the rarity of ider(17)(q10)t(15;17) in microgranular APL, further studies on both gene dosage effect of this chromosomal abnormality and the influence of ider(17)(q10)t(15;17) on clinical features such as prognosis, survival, and treatment response of APL cases are recommended.

Keyword

ider(17)(q10)t(15;17); Old-age; Microgranular; Acute promyelocytic leukemia

MeSH Terms

Bone Marrow Cells/pathology
*Chromosomes, Human, Pair 15
*Chromosomes, Human, Pair 17
Female
Humans
In Situ Hybridization, Fluorescence
Karyotyping
Leukemia, Promyelocytic, Acute/*diagnosis/genetics/pathology
Middle Aged
Oncogene Proteins, Fusion/genetics
*Translocation, Genetic

Figure

• 

  Fig. 1 Bone marrow aspiration showing abnormal promyelocytes with sparse and/or fine granulation (dotted arrows), bilobed or "butterfly"-shaped nucleus (a horizontal arrow), cerebriform nucleus (an oblique arrow) and "salmon pink"-colored cytoplasm (a vertical arrow) at diagnosis (Wright-Giemsa stain,×1,000).

• 

  Fig. 2 Chromosome and FISH studies at initial diagnosis. (A) Full karyogram of the bone marrow cells (major clone) at diagnosis: 46,XX,del(6)(?q21q25),der(15)t(15;17)(q22;q12),ider(17)(q10)t(15;17). The arrows indicate abnormal chromosomes in this karyogram. (B) Partial karyograms (chromosomes 15 and 17) of the bone marrow cells at diagnosis: Upper image: t(15;17)(q22;q12) associated with ider(17)(q10)t(15;17). Lower image: t(15;17)(q22;q12) associated with double ider(17)(q10)t(15;17). (C) FISH study using a PML-RARA dual-color, dual-fusion translocation probe (Abbott Molecular/Vysis, USA) at diagnosis. The arrows indicate the PML-RARA or RARA-PML fusion signals. Left image: ider(17)(q10)t(15;17) clone (3 fusion signals). Right image: double ider(17)(q10)t(15;17) clone (5 fusion signals).

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