Microgranular acute promyelocytic leukemia--a case with multiple Auer rods demonstrable only after staining for chloroacetate esterase.

ABSTRACT

In the past several years there has been increasing recognition of the microgranular variant of acute promyelocytic leukemia (APL). This variant is easily mistaken for other types of acute non-lymphocytic leukemia. Its recognition is important because it carries the same high risk of disseminated intravascular coagulation as typical APL. An important clue to the correct diagnosis is the recognition of small numbers of characteristic cells containing multiple Auer rods. This report presents a case in which such Auer-body-containing cells were demonstrable in the marrow only after staining for chloroacetate esterase. They were not apparent with Wright's stain or Sudan black B. The case also highlights the occurrence of variant APL in children and adolescents.