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HORIBA Chase the Case #57 - Acute Promyelocytic Leukemia
See how Yumizen H2500 hematology analzyer and Yumizen D20 digital morhology system flag immature myeloid cells to support faster acute leukemia detection.
June 2026 (PDF for print)
Patient Demography: Male, 44 years old.
Clinical Presentation: The patient presented with high fever, bone pain, and weakness.
Microscopic Review: 94% blasts/abnormal promyelocytes, 4% segmented neutrophils, 2% lymphocytes.
Blast Morphology: The smear shows the morphology of abnormal promyelocytes, which are large cells with a round, eccentric nucleus, quite fine chromatin with a nucleolus, very basophilic cytoplasm with a light perinuclear area, and many primary azurophilic granules covering the cytoplasm and nucleus. Many of the blasts show the presence of Auer rods.
Other Tests: High PT, APTT, and D-dimer; immunophenotyping.
Diagnosis: The morphological features and flow cytometry reports are suggestive of acute promyelocytic leukemia.
How Yumizen can assist: On the DIFF scattergram of the Yumizen H2500 analyzer, with its capability of showing an extended WBC differential matrix, an isolated population can be observed in continuation, emerging from the neutrophil and monocyte matrix and moving toward the IMG and IMM matrices. This population corresponds to the presence of immature myeloid-series cells, showing high LIC values along with high IMM and high IMG. The population described on the matrix and the microscopic picture captured on the Yumizen D20 digital morphology system as "Atypical/Blast" and "Promyelocyte" categories complements the immature WBC parameters (LIC, IMM, and IMG) of the Yumizen H2500, supporting the screening and diagnosis of acute leukemia.
Abnormal Promyelocyte
Large cells with an irregular nuclear membrane, nuclear folding, a butterfly-shaped nucleus, open chromatin, a prominent nucleolus, and granular cytoplasm.
This clinical case has been provided by a laboratory in India.
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