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172 cs: Mikrogranulární varianta APL
en: Microgranular variant APL
10 A. Buliková, J. Kissová 21.7.2008, 17:58 9.9.2009, 21:29 9.9.2009, 21:29 J. Kissová


Nalezené obrázky* (n=24)

AML without maturation- BM
Bone marrow is rich and infiltrated by uniform population of myeloblasts. There are only two lymphocytes (in the middle and at 6 o'clock) there; they can be distinguished by mature chromatin and markable smaller cell¨s size. One promyelocyte - large cell, ex-centric nucleus, numerous azurophilic granulation - is at the bottom of the picture (8 o'clock).  / Kostní dřeň je bohatá a infiltrovaná uniformní populací myeloblastů. Jsou zde jen dva lymfocyty (uprostřed a na 6. hodině); tyto mohou být odlišeny podle zralého chromatinu a zřetelně menší velikosti buňky. Jeden promyelocyt - větší buňka, excentrické jádro, početná azurofilní granulace - je v dolní části obrázku (na 8. hodině). Description: Bone marrow is rich and infiltrated by uniform population of myeloblasts. There are only two lymphocytes (in the middle and at 6 o'clock) there; they can be distinguished by mature chromatin and markable smaller cell¨s size. One promyelocyte - large cell, ex-centric nucleus, numerous azurophilic granulation - is at the bottom of the picture (8 o'clock).
Type: bone marrow
Klíčová slova*: myeloblast, promyelocyte, lymphocyte
microgranular variant APL- BM
Four tumour cells in variant APL with bi-lobar nuclei, rather fine cytoplasmic granulation and cytoplasmic projections at the outline of the cell.  There is one typical hypergranular promyelocyte at the upper left with cytoplasm filed by large numerous azurophilic granules, which totally obscure the nuclear cytoplasmic margin.  / Čtyři nádorové buňky u varinatní APL s bilobárními jádry, spíše jemnou cytoplazmatickou granulací a cytoplazmatickými výběžky na zevním obvodu buňky. Jeden typický hypergranulární promyelocyt je nahoře vlevo s cytoplazmou naplněnou velkými početnými azurofilními granuly, která úplně zakrývají rozhraní mezi jádrem a cytoplazmou. Description: Four tumour cells in variant APL with bi-lobar nuclei, rather fine cytoplasmic granulation and cytoplasmic projections at the outline of the cell. There is one typical hypergranular promyelocyte at the upper left with cytoplasm filed by large numerous azurophilic granules, which totally obscure the nuclear cytoplasmic margin.
Type: bone marrow
Klíčová slova*: promyelocyte
microgranular variant APL- BM
In all cases of acute leukaemia with bilobar nuclei it is really necessary carefully search for cells with bundles Auer rods in cytoplasm ("faggot cells"). This finding brings high suspicion to diagnose of microgranular variant of APL, which should be confirmed by cytogenetic and/or molecular genetic examination - presence of 
t(15;17) and/or PML/RARalfa fusion gene.    / Ve všech případech akutní leukémie s bilobárními jádry je opravdu nezbytné pečlivě pátrat po buňkách se snopci Auerových tyčí v cytoplazmě ("faggot cells"). Tento nález přináší vysoké podezření na diagnózu mikrogranulární varianty APL, která by měla být potvrzena cytogenatickým a/nebo molekulárně genatickým vyšetřením - přítomnost t(15;17) a/nebo PML/RARalfa fúzního genu. Description: In all cases of acute leukaemia with bilobar nuclei it is really necessary carefully search for cells with bundles Auer rods in cytoplasm ("faggot cells"). This finding brings high suspicion to diagnose of microgranular variant of APL, which should be confirmed by cytogenetic and/or molecular genetic examination - presence of t(15;17) and/or PML/RARalfa fusion gene.
Type: bone marrow
Klíčová slova*: promyelocyte, Auer rod, faggot cell
microgranular variant APL- BM
Bi-lobular or multilobular (cell at the middle right) nuclei and fine reddish granulation in cytoplasm are also typical in tumour cells in  bone marrow.  / Bilobární nebo multilobulární (buňka ve středu vpravo) jádra a jemná načervenalá granulace v cytoplazmy jsou typické taktéž v nádorových buňkách kostní dřeně. Description: Bi-lobular or multilobular (cell at the middle right) nuclei and fine reddish granulation in cytoplasm are also typical in tumour cells in bone marrow.
Type: bone marrow
Klíčová slova*: promyelocyte
microgranular variant APL- PB
Numerous bi-lobar or kidney shaped nuclei and agranular or fine granular cytoplasm in "promyelocytes" in peripheral blood smears in patient with AML M3v. Cytoplasm of some cells (example at upper left) can contain more pronounced usually isolated red inclusion.  / Početná bilobární či ledvinovitá jádra a agranulární či jemně granulovavaná cytoplazma v "promyelocytech" nátěru periferního krvi u pacienta s AML M3v. Cytoplazma některých buněk (příklad vlevo nahoře) mohou obsahovat více vyjádřené obvykle izolované červené inkluze. Description: Numerous bi-lobar or kidney shaped nuclei and agranular or fine granular cytoplasm in "promyelocytes" in peripheral blood smears in patient with AML M3v. Cytoplasm of some cells (example at upper left) can contain more pronounced usually isolated red inclusion.
Type: peripheral blood
Klíčová slova*: promyelocyte
microgranular variant APL- PB
Bi-lobar nucleus and clear Auer rod but in almost agranular cytoplasm are typical features in the cell at upper left. Two large lobes of nucleus joined by a narrow bridge (cell at the 3 o'clock) present another characteristics of the variant form PML.  / Bilobární jádro a  jasná Auerova tyč, ale v téměř agranulární cytoplazmě,  jsou typické známky v buňce nahoře vlevo. Dva velké laloky jádra spojené tenkým můstkem (buňka na 3. hodině) představují jiné charakteristické rysy variantní formy PML. Description: Bi-lobar nucleus and clear Auer rod but in almost agranular cytoplasm are typical features in the cell at upper left. Two large lobes of nucleus joined by a narrow bridge (cell at the 3 o'clock) present another characteristics of the variant form PML.
Type: peripheral blood
Klíčová slova*: promyelocyte
microgranular variant APL- PB
Tumour cell with bi-lobar nucleus, clear nucleoli in every nuclear part, some (upper left) or no (lower right) cytoplasmic granulation.  / Nádorové buňky s bilobárním jádrem, jasnými jadérky v každé části jádra, nějakou (vlevo nahoře) nebo žádnou (vpravo dole) cytoplazmatickou granulací. Description: Tumour cell with bi-lobar nucleus, clear nucleoli in every nuclear part, some (upper left) or no (lower right) cytoplasmic granulation.
Type: peripheral blood
Klíčová slova*: promyelocyte, tumour cell
microgranular variant APL- PB
Some pathological promyelocytes are completely agranular (lower left) with kidney shaped nucleus. Some Auer rods even in bundles can be find almost in every cases - in this one there are 3-4 thick Auer rods in the second cell from bellow at right.   / Některé patologické promyelocyty jsou úplně agranulární (vlevo dole) s ledvinovým tvarem jádra. Auerovy tyče  dokonce ve snopcích mohou být nalezeny téměř ve všech případech - v tomto jsou 3-4 silné Auerovy tyče ve druhé buňce zespodu vpravo. Description: Some pathological promyelocytes are completely agranular (lower left) with kidney shaped nucleus. Some Auer rods even in bundles can be find almost in every cases - in this one there are 3-4 thick Auer rods in the second cell from bellow at right.
Type: peripheral blood
Klíčová slova*: promyelocyte, Auer rod
microgranular variant APL-PB
The main feature of this type acute myeloblastic leukaemia is bi-lobed nuclear shape and presence of dust-like reddish granules in cytoplasm. Some tumour cells can be even agranular. Leukocytosis is usual when one compares this type with classic hyper-granular form.   / Hlavním rysem tohoto typu akutní myeloblastické leukémie je bilobární tvar jádra a přítomnost prachových načervenalých granulí v cytoplazmě. Některé nádorové buňky mohou být dokonce agranulární. Leukocytóza je obvykla v porovnání s klasickou hypergranulární variantou. Description: The main feature of this type acute myeloblastic leukaemia is bi-lobed nuclear shape and presence of dust-like reddish granules in cytoplasm. Some tumour cells can be even agranular. Leukocytosis is usual when one compares this type with classic hyper-granular form.
Type: peripheral blood
Klíčová slova*: promyelocyte, tumour cell
Anaplastic large cell lymphoma - ALK negative
Three tumour cells in ALCL. They have pale basophilic cytoplasm, fine reticular nuclear chromatin and few dark blue nucleoli. There are two nuclear fragments in cytoplasm one of them (upper left). At the upper right are two   immature neutrophils (upper promyelocyte, lower myelocyte).     / Tři nádorové buňky u ALCL. Mají světle bazofilní cytoplazmu, jemný síťovitý jaderný chromatin a několik tmavě modrých jadérek. V cytoplazmě jedné z nich jsou dva jaderné fragmenty (nahoře vlevo). Nahoře vpravo jsou dva nezralé neutrofily (horní promyelocyt, dolní myelocyt). Description: Three tumour cells in ALCL. They have pale basophilic cytoplasm, fine reticular nuclear chromatin and few dark blue nucleoli. There are two nuclear fragments in cytoplasm one of them (upper left). At the upper right are two immature neutrophils (upper promyelocyte, lower myelocyte).
Type: bone marrow
Klíčová slova*: promyelocyte, myelocyte, tumour cell
Chronic myelogenous leukaemia - chronic phase
Although predominant populations in peripheral blood smears in the disease represent mature segmented neutrophils and myelocytes, all type of immature cells of granulocytic lineage can occur. There are two bands in the picture (2 o'clock and 7 o'clock), and there is one promyelocyte (at 8 o'clock).      / I když dominujícími populacemi u této choroby jsou v nátěru periferní krve neutrofilní segmenty a myelocyty, mohou se objevit všechny nezralé buňky granulocytární řady. Na obrázku jsou dvě tyče (na 2. a 7. hodině) a promyelocyt (na 8. hodině). Description: Although predominant populations in peripheral blood smears in the disease represent mature segmented neutrophils and myelocytes, all type of immature cells of granulocytic lineage can occur. There are two bands in the picture (2 o'clock and 7 o'clock), and there is one promyelocyte (at 8 o'clock).
Type: peripheral blood
Klíčová slova*: promyelocyte, myelocyte, band, segmented granulocyte
CML accelerated phase - PB
Marked leucocytosis with granulocytosis. Myelocytes and segmented granulocytes are predominant elements of peripheral blood, marked basophilia. At the picture blasts and promyelocytes are present, six basophiles.
 / Výrazná leukocytóza s granulocytózou. Myelocyty a neutrofilní segmenty jsou dominujícími elementy v nátěrech periferní krve, výrazná bazofílie. Na obrázku přítomny i blasty a promyelocyty, šest bazofilů. 


Description: Marked leucocytosis with granulocytosis. Myelocytes and segmented granulocytes are predominant elements of peripheral blood, marked basophilia. At the picture blasts and promyelocytes are present, six basophiles.
Type: peripheral blood
Klíčová slova*: myeloblast, promyelocyte, myelocyte, basophil, segmented granulocyte
AML- peripheral blood
The II-nd type myeloblast. Cell with fine chromatin structure, high nucleus/cytoplasm ratio, three clear nucleoli. Large centrosome is discernible as a lighter juxtanuclear zone with a slight depression of the nucleus; this is sing of more mature cell ( promyelocyte of normal bone marrow). The apparent Auer rod is in the cytoplasm of the cell. . / Myeloblast II. typu. Buňka s jemnou strukturou chromatinu, vysokým nukleo/cytoplazmatickým poměrem, třemi jadérky. Velký centrosom je rozeznatelný jako světlejší juxtanukleární oblast s promáčknutím jádra; to je známka více zralé buňky (promyelocyt v normální kostní dřeni). Zřetelná Auerova tyč je v cytoplazmě buňky. Description: The II-nd type myeloblast. Cell with fine chromatin structure, high nucleus/cytoplasm ratio, three clear nucleoli. Large centrosome is discernible as a lighter juxtanuclear zone with a slight depression of the nucleus; this is sing of more mature cell ( promyelocyte of normal bone marrow). The apparent Auer rod is in the cytoplasm of the cell. .
Type: peripheral blood
Klíčová slova*: myeloblast, Auer rod
APL- bone marrow 4
Smear show typical pathological cells of acute promyelocytic leukamia - hypergranulated abnormal promyelocyte and "faggot cells". Rest of cells are  two normoblasts and damaged cells. / Nález ukazuje typické patologické elementy akutní promyelocytární leukémie- hypergranulované abnormální  promyelocyty a tzv."faggot cells". Zbytek buněk tvoří dva normoblasty a rozbité buňky. Description: Smear show typical pathological cells of acute promyelocytic leukamia - hypergranulated abnormal promyelocyte and "faggot cells". Rest of cells are two normoblasts and damaged cells.
Type: bone marrow
Klíčová slova*: faggot cell
AML M2- bone marrow 1
In the center two blasts and promyelocyte, one blast with single Auer rod. / V centru dva blasty a promyelocyty , jeden blast se solitární Auerovou tyčí. Description: In the center two blasts and promyelocyte, one blast with single Auer rod.
Type: bone marrow
Klíčová slova*: myeloblast, promyelocyte, Auer rod
AMML Eo bone marrow
Hyper-cellular bone marrow with mixture of tumour cells of granulocytic and monocytic lineages. Two characteristic eosinophil myelocytes, that in at right has vacuolized cytoplasm. Eosinophil the mostly at right is promyelocyt with numerous purple pro-granules.    / Hypercelulární kostní dřeň se směsí nádorových buněk granulocytární a monocytární linie. Dva charakteristické eozinofilní myelocyty, ten vpravo má vakuolizovanou cytoplazmu. Eozinofil nejvíce vpravo je promyelocyt s početnými purpurovými progranuly. Description: Hyper-cellular bone marrow with mixture of tumour cells of granulocytic and monocytic lineages. Two characteristic eosinophil myelocytes, that in at right has vacuolized cytoplasm. Eosinophil the mostly at right is promyelocyt with numerous purple pro-granules.
Type: bone marrow
Klíčová slova*: myeloblast, promyelocyte, eosinophil, promonocyte, monocyte
AMML Eo bone marrow
Blasts and promonocytes, eosinophils with atypical "basophil like" granulation. One promyelocyte at 5 o' clock. Eosinophil component reaches almost 14% of nucleated bone marrow cells.  / Blasty a promonocyty, eozinofily s atypickou granulací napodobující "basofilní". Jeden promyelocyt na 5. hodině. Eozinofilní komponenta dosahuje téměř 14% z jaderných buněk kostní dřeně. Description: Blasts and promonocytes, eosinophils with atypical "basophil like" granulation. One promyelocyte at 5 o' clock. Eosinophil component reaches almost 14% of nucleated bone marrow cells.
Type: bone marrow
Klíčová slova*: eosinophil, promonocyte
AMML Eo bone marrow
Several blasts with heterogeneous morphology, one monocyte and two eosinophils. This one at the left is really immature (promyelocyte), has a few large granules purple-violet in colour reminding basophilic granulation mixing with eosinophlic granules.  Naked nuclei and damaged cells. / Několik blastů různorodé morfologie, jeden monocyt a dva eozinofily. Ten vlevo je skutečně nezralý (promyelocyt), má několik velkých granulí purpurově-fialové barvy připomínající basofilní granulaci smíchaných s granulemi eozinofilními. Holá jádra a poškozené buňky. Description: Several blasts with heterogeneous morphology, one monocyte and two eosinophils. This one at the left is really immature (promyelocyte), has a few large granules purple-violet in colour reminding basophilic granulation mixing with eosinophlic granules. Naked nuclei and damaged cells.
Type: bone marrow
Klíčová slova*: myeloblast, eosinophil, monocyte
MDS RAEB II
In the upper part of the picture note a myeloblast wiht Auer rods, and  nucleoli. Below this cell  there is a  plasmatic cell and two promyelocytes.
On the right there  is a group of two megaloblasts and two normoblast.   / V horní části obrázku  leží myeloblast s několika Auerovými tyčemi, v jádře zřetelná jadérka, pod ním plasmatická buňka a dva promyelocyty.
Vpravo skupina erytroblastů se 2 normoblasty a 2 megaloblasty.

Description: In the upper part of the picture note a myeloblast wiht Auer rods, and nucleoli. Below this cell there is a plasmatic cell and two promyelocytes. On the right there is a group of two megaloblasts and two normoblast.
Type: bone marrow
Klíčová slova*: myeloblast, normoblast, plasma cell, megaloblast, Auer rod
APL- bone marrow 3
At centre of the picture are two "faggot cells"  on the right, two abnormal hypergranular promyelocytes on the left-  one with cleaved or bilobated nucleus. Below are two hypergranular myelocytes with large reddish inclusions- upper myelocyt with cleaved nucleus, both of them are impaired. / Uprostřed snímku jsou dvě "faggot cells" vpravo, dva abnormální hypergranulované promyelocyty vlevo- jeden s rozštěpeným nebo dvoulaločnatým jádrem. Pod nimi dva hypergranulované myelocyty s objemnými inkluzemi- horní buňka s rozštěpeným jádrem, obě jsou poškozené. Description: At centre of the picture are two "faggot cells" on the right, two abnormal hypergranular promyelocytes on the left- one with cleaved or bilobated nucleus. Below are two hypergranular myelocytes with large reddish inclusions- upper myelocyt with cleaved nucleus, both of them are impaired.
Type: bone marrow
Klíčová slova*: myelocyte, faggot cell, hypergranulation
APL- peripheral blood 6
Pseudo Chediak-Higashi granule in hypergranulated promyelocyte. Two mature lymphocytes with short polar villi, but along the spread (artificial). / Pseudo Chediak- Higashiho granula u hypergranulovaného promyelocytu. Dva zralé lymfocyty s krátkými "vlásky" na pólech buňky, ale ve směru nátěru (arteficiálně). Description: Pseudo Chediak-Higashi granule in hypergranulated promyelocyte. Two mature lymphocytes with short polar villi, but along the spread (artificial).
Type: peripheral blood
Klíčová slova*: promyelocyte, lymphocyte, hypergranulation
APL- peripheral blood 5
At top is abnormal promyelocyte with large numerous granules, in comparison below is mature basophil. / Nahoře abnormální promyelocyt s objemnou početnou granulací, ke srovnání dole zralý bazofil. Description: At top is abnormal promyelocyte with large numerous granules, in comparison below is mature basophil.
Type: peripheral blood
Klíčová slova*: promyelocyte, basophil
APL- peripheral blood 4
Hypergranular promyelocyte with large reddish inclusion (pseudo Chediak-Higashi granule). / Hypergranulovaný promyelocyt s objemnou inkluzí (pseudo Chediak- Higashiho granula). Description: Hypergranular promyelocyte with large reddish inclusion (pseudo Chediak-Higashi granule).
Type: peripheral blood
Klíčová slova*: promyelocyte, hypergranulation
APL- peripheral blood 1
At centre of the picture abnormal  promyelocyte with cleaved nucleus. / Uprostřed snímku abnormální promyelocyt s rozštěpeným jádrem. Description: At centre of the picture abnormal promyelocyte with cleaved nucleus.
Type: peripheral blood
Klíčová slova*: promyelocyte