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Bronchoalveolar lavage fluid review in acute promyelocytic leukemia differentiation syndrome
- Source :
- Journal of Hematopathology
- Publication Year :
- 2021
- Publisher :
- Springer Berlin Heidelberg, 2021.
-
Abstract
- The patient was a 62-year-old Caucasian man with blood smear and flow cytometry concerning for acute promyelocytic leukemia with FISH ultimately confirming PML-RARA translocation. He had a 30-year history of employment at a nuclear power plant. He presented with diffuse intravascular coagulation, hyperleukocytosis, and quickly developed acute respiratory distress syndrome. On day four of ATRA + Hydrea, a bronchoalveolar lavage was performed and was non-bloody. On microscopic fluid review, abnormal immature cells with bilobed nuclear contours were identified, similar in morphology to those seen on the diagnostic blood smear review, amidst background alveolar-type macrophages. Subsequent flow cytometric analysis showed these cells to be abnormal promyelocytes; however, they differed from the blood flow cytometry study performed prior to initiation of ATRA by showing maturational immunophenotypic changes. While the leukemic promyelocytes on bronchoalveolar lavage were morphologically immature, these immunophenotypic changes somewhat recapitulated those seen in normal granulocyte maturation and were thus suggestive of so-called differentiation syndrome. Unfortunately, the patient passed away during induction chemotherapy due to complications from diffuse intravascular coagulation and differentiation syndrome. Important pathobiological information can be gathered from fluid review and concomitant flow cytometric analysis.
- Subjects :
- Acute promyelocytic leukemia
medicine.medical_specialty
Pathology
Histology
Case Report
Granulocyte
Pathology and Forensic Medicine
Flow cytometry
Internal medicine
medicine
Fluid review
ATRA
Hematology
medicine.diagnostic_test
business.industry
Induction chemotherapy
medicine.disease
Blood Flow Cytometry
APL
Bronchoalveolar lavage
medicine.anatomical_structure
Differentiation syndrome
business
Promyelocyte
Subjects
Details
- Language :
- English
- ISSN :
- 18655785 and 18689256
- Database :
- OpenAIRE
- Journal :
- Journal of Hematopathology
- Accession number :
- edsair.doi.dedup.....be71f4f452b202fe26fdab16750dabf9