Cytomorphologic differentiation of common acute lymphoblastic leukemia from other immunologic subtypes. Report of a case of peripheral relapse with cytochemical and immunochemical study.

ABSTRACT

Of the subtypes of acute lymphoblastic leukemia (ALL), the "common" subtype (c-ALL) bears the best prognosis. Nevertheless, there has been no report of cytologic criteria that can distinguish c-ALL from the B-cell (B-ALL) and T-cell (T-ALL) subtypes. We present a case of c-ALL with relapse, with cytochemical and immunocytochemical as well as cytologic studies. Certain cytologic observations in this case could serve to differentiate c-ALL from B-ALL and T-ALL; the morphologic criteria suggested have been seen by us in other c-ALL cases. We think they will be useful in future fine needle aspiration studies in order to demonstrate extramedullary relapses as well as to differentiate ALL subtypes without the need of more costly immunologic studies.