Acute erythroblastic leukemia presenting as acute undifferentiated leukemia: A report of two cases with ultrastructural features

Bernard, Philippe; Larrue, J; Dachary, Dominique; David, B.; Boisseau, M. R.; Broustet, A

doi:10.1016/0145-2126(85)90064-5

Cited by 18 publications

(7 citation statements)

References 20 publications

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“…Here, we described the BM biopsy findings and autopsy findings in an elderly female patient with a diagnosis of AEL of the EL subtype. Autopsy reports of AEL are extremely rare in the literature in English 11 , 15. The new, stricter, criteria established in the latest WHO classification of AML1 will certainly contribute to a deeper understanding of AEL and allow future molecular biology studies to define molecular markers of AEL.…”

Section: Discussionmentioning

confidence: 99%

Acute erythroid leukemia: autopsy report of a rare disease

Ferreira¹,

Lima²,

Goto³

et al. 2011

ACR

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Acute erythroid leukemia (AEL) is a rare subtype of acute myeloid leukemia (AML), characterized by predominant erythroid proliferation. The 2008 World Health Organization (WHO) classification of AML defined two AEL subtypes: erythroleukaemia (EL), in which erythroid precursors account for 50% or more of all nucleated bone marrow cells and myeloblasts account for 20% or more of the nonerythroid cell population; and pure erythroid leukemia (PEL), in which erythroid precursors account for 80% or more of all nucleated bone marrow cells. We report the case of an elderly female patient with wasting syndrome and pancytopenia without evidence of blasts in peripheral blood. A diagnosis of PEL was established on the basis of bone marrow biopsy findings. The patient died on postadmission day 20, and an autopsy was performed. We reclassified the disease as EL on the basis of the autopsy findings, which included myeloblasts accounting for more than 20% of the nonerythroid cells in the bone marrow, as well as leukemic infiltration and myeloid metaplasia in solid organs, such as the liver, spleen, kidneys, adrenal glands, and abdominal lymph nodes. A rare disease, AEL accounts for less than 5% of all AMLs and is practically a diagnosis of exclusion. Autopsy reports of AEL are extremely rare in the literature. We demonstrate that in the case reported here, leukemia cells tended to infiltrate solid organs with myeloid metaplasia. Our findings also show that a larger neoplastic bone marrow sample is crucial to the correct diagnosis of EL, which is based on morphological and quantitative criteria.

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Section: Discussionmentioning

confidence: 99%

Acute erythroid leukemia: autopsy report of a rare disease

Ferreira¹,

Lima²,

Goto³

et al. 2011

ACR

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“…In most of the cases reported, including ours, the blast cells show basophilic cyto plasm frequently vacuolated, leading to the diagnosis of acute leukemia L3 type in some instances [1], Ultrastructural features such as glycogen deposits, lipidic vacuoles, cytoplasmic free ferritin and rhopheocytosis may be helpful in the diagnosis of AEL [3]. Recently, granules resembling 0 granules which con tained ferritin molecules have been described in blast cells of erythroid leukemias [15].…”

Section: Discussionmentioning

confidence: 99%

“…AEL seems to be extremely uncommon among 'de novo' acute leukemias and to describe it, several terms have been used: acute erythroleukemia [1], 'cryptic' erythroleukemia [2], acute erythroblastic leu kemia [3], early erythroblastic leukemias [4] and acute poorly differentiated erythroid leukemia [5], AEL must be distinguished from other hemato logic neoplastic disorders with erythroid involvement such as erythroleukemia (M6), acute erythremia and erythroid blast crisis of chronic myelogenous leu kemia. The differential diagnosis of these disorders is made on the basis of cytological and immunological characteristics of the leukemic cells.…”

Section: Discussionmentioning

confidence: 99%

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Acute Erythroblastic Leukemia

Soler

Pujol-Moix²,

Bosch³

et al. 1989

Acta Haematol

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We report the clinical, cytological, immunophenotypic, and cytogenetic findings in one patient with acute erythroblastic leukemia. Blast cells were identified by their reactivity with the early erythroid antibodies FA6–152 and carbonic anhydrase I. The leukemic blasts had no specific differentiating features identifying them as erythroblasts even at an ultrastructural level. Cytogenetic studies revealed multiple chromosome aberrations: 45, XX, i(11q), -16, -17, -21, + der(21) t(21;?)(q22;?), + mar 1.

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“… 6 The autopsy findings of this entity are described in only occasional anecdotes. 7 - 17 Besides, the histomorphological features at autopsy can be challenging. We hereby describe the complete autopsy findings of a case of AEL in an older man.…”

Section: Introductionmentioning

confidence: 99%

Autopsy findings of acute erythroid leukemia

Parkhi¹,

Mallik²,

Lad³

et al. 2023

Autops Case Rep

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Acute erythroid leukemia (AEL) is an exceedingly uncommon but distinct hematological malignancy that shows neoplastic proliferation of erythroid precursors with maturation arrest and no significant myeloblasts. We describe an autopsy case of this rare entity in a 62-year-old man with co-morbidities. He underwent a bone marrow (BM) examination for pancytopenia during the first outpatient department visit, which revealed an increased number of erythroid precursors with dysmegakaryopoiesis suggesting the possibility of Myelodysplastic syndromes (MDS). Thereafter, his cytopenia got worsened, warranting blood and platelet transfusions. Four weeks later on the second BM examination, AEL was diagnosed based on morphology and immunophenotyping. Targeted resequencing for myeloid mutations revealed TP53 and DNMT3A mutations. He was initially managed along febrile neutropenia with the stepwise escalation of antibiotics. He developed hypoxia attributed to anemic heart failure. Subsequently, he had hypotension and respiratory fatigue pre-terminally and succumbed to his Illness. A complete autopsy showed infiltration of various organs by AEL and leukostasis. Besides, there was extramedullary hematopoiesis, arterionephrosclerosis, diabetic nephropathy (ISN-RPS class II), mixed dust pneumoconiosis, and pulmonary arteriopathy. The histomorphology of AEL was challenging, and the differential diagnoses were many. Thus, this case highlights the autopsy pathology of AEL, an uncommon entity with a strict definition, and its relevant differentials.

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Acute erythroblastic leukemia presenting as acute undifferentiated leukemia: A report of two cases with ultrastructural features

Cited by 18 publications

References 20 publications

Acute erythroid leukemia: autopsy report of a rare disease

Acute erythroid leukemia: autopsy report of a rare disease

Acute Erythroblastic Leukemia

Autopsy findings of acute erythroid leukemia

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