Ann Lab Med.  2014 Mar;34(2):155-158. 10.3343/alm.2014.34.2.155.

Therapy-Related Acute Megakaryoblastic Leukemia in a Lung Cancer Patient

• Moon JJ
• Nam MH
• Lim CS
• Lee CK
• Cho Y
• Yoon SY

• KMID: 1791911
• DOI: http://doi.org/10.3343/alm.2014.34.2.155

Abstract

No abstract available.

MeSH Terms

Aged
Antineoplastic Combined Chemotherapy Protocols/adverse effects/*therapeutic use
Blood Cells/pathology
Bone Marrow Cells/pathology
Carcinoma, Non-Small-Cell Lung/*drug therapy/radiotherapy
Humans
Karyotyping
Leukemia, Megakaryoblastic, Acute/*diagnosis/etiology
Lung Neoplasms/*drug therapy/radiotherapy
Male

Figure

• 

  Fig. 1 (A) Peripheral blood (PB) smear findings (Wright-Giemsa stain, ×1,000), (B) bone marrow (BM) aspirate smear (Wright-Giemsa stain, ×1,000), and (C) BM biopsy section (H&E stain, ×1,000). Cells in the PB smear (A) had dysplastic features, such as marked anisopoikilocytosis, and some red blood cells (RBCs) had a teardrop shape. Neutrophils showed the Pelger-Huët anomaly and cytoplasmic hypogranularity. Leukemic blasts (B), consistent with acute megakaryoblastic leukemia, were of medium to large size and had round, slightly irregular or indented nuclei, with fine reticular chromatin, one to three inconspicuous nucleoli, basophilic agranular cytoplasm, and frequent pseudopod formation. The biopsied marrow (C) showed hypercellularity relative to the patient's age (approximately 70%). (D) The karyotype of the abnormal clone in 2 out of 20 analyzed metaphase cells using G-banding. It was initially interpreted as 46,XY,-5,-7,+2mar. The arrows denote the abnormal chromosomes. (E-G) Interphase FISH for AML1-ETO (E), RELN/TES (F), andTAS2R1/EGR1 (G) at diagnosis. The three green (RUNX1 probe on 21q22) and two orange (RUNX1T1 probe on 8q22) signals (E) were consistent with an additional AML1 signal in 28.2% of the nuclei analyzed. The two green (D5S630 probe on 5p15.31) and one orange (EGR1 probe on 5q31) signal (F) and one green (RELN probe on 7q22) and one orange (TES probe on 7q31) signal (G) were consistent with 5q and 7q deletions, respectively. The two green (D5S630 probe on 5p15.31) signals (F) signified that there were two 5p loci.Abbreviation: H&E, hematoxylin and eosin.

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