Acute leukemia with myeloid, B-, and natural killer cell differentiation.
Biphenotypic acute leukemias account for 4% to 8% of all acute leukemias. Most of these leukemias are of myeloid-B-cell or myeloid-T-cell lineage. Acute myeloid-natural killer cell leukemia has been recognized recently. We report the first case, to our knowledge, of CD56(+) acute leukemia showing unequivocal myeloid and B-cell differentiation in a 20-year-old woman, whose blast cells were positive for myeloperoxidase, CD13, CD33, CD117, terminal deoxynucleotidyl transferase, CD19, CD20, CD22, CD34, HLA-DR, and CD56 but negative for CD3, CD5, CD7, and CD10. Rare Auer rods were identified in the blast cells. Polymerase chain reaction assays showed rearrangement of immunoglobulin heavy-chain gene and absence of Epstein-Barr virus DNA. We propose that this novel form of multilineage leukemia may represent the neoplastic counterpart of a progenitor that can give rise to myeloid, B, and natural killer cells.
Lee
Po-Shing
PS
Department of Pathology, Chi Mei Foundation Medical Center, Yungkang City, Tainan. poshing.lee@impath.com
Lin
Ching-Nan
CN
Liu
Chientzu
C
Huang
Chien-Tai
CT
Hwang
Wei-Shiou
WS
D000208:Acute Disease; D000328:Adult; D001402:B-Lymphocytes / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D002454:Cell Differentiation; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D005260:Female; D019675:Genes, T-Cell Receptor gamma; D006801:Humans; D016130:Immunophenotyping; D007694:Killer Cells, Natural / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000201:enzymology; D016131:Lymphocyte Subsets / Q000201:enzymology / Q000378:metabolism* / Q000473:pathology