Cytoplasmic blebbing in blasts of all cases, cytoplasmic vacoulation was seen in three cases, nuclear clefting in one, auer rod
in one while giant platelets and aggregates of blasts were found in case IV.
Hutter G, Nowak D, Blau IW, Thiel E: Auer rod
like intracytoplasmic inclusions in multiple myeloma.
In one survey, the CAP received the following five different identifications on a hematology slide: segmented neutrophil, Auer rod
, toxic granulation, Barr body, and Dohle inclusion body.
Morphology showed normochromic, anisocytosis, Rouleaux formation, circulating blast cells with Auer rods
, bicytopenia with leukocytosis, neutrophils: 0.
Faggot cells with multiple Auer rods
are less commonly seen.
2] Characteristic cells containing bundles of Auer rods
(faggots) randomly distributed in the cytoplasm are almost invariably present in the bone marrow and sometimes in the peripheral blood.
A cytochemical and ultrastructural study of acute myelomonocytic leukemia exhibiting the pseudo-Chediak-Higashi anomaly of leukemia and "splinter-type" Auer rods
0% Platelets 30 K/[mu]L 150-450 K/[mu]L Differential Neutrophils 3% 33-61% Lymphocytes 10% 25-45% Blasts 87% 0% Nucleated RBC's 2 RBC Morphology Polychromasia WBC Morphology Auer rods
present D-Dimer 18.
Hypergranular acute promyelocytic leukemia (APL): The most common morphologic variant of APL, representing approximately 75% of cases, is characterized by bone marrow containing large, abnormal promyelocytes with pleomorphic nucleoi and cytoplasm containing coarse, large granules with abundant Auer rods
, often in bundles.
In the typical case of APL, diagnosis is not difficult, as the neoplastic population consists of numerous cytologically atypical cells that resemble promyelocytes, frequently containing single or multiple Auer rods
(Figure 1, A).
Occasional blasts, especially the more mature forms, may contain blunted Auer rods
Morphological tinclings of pathological "clonal" blasts (type II that contain Auer rods
, Pseudo-Chediak-Higashi or other specific inclusions that are not seen in reactive marrow) refer to the diagnosis of RAEB-2 or AML; here again the arbitrary cut-off point of 20% blasts results in a specific diagnosis.