Granular Acute Lymphoblastic Leukemia in Adults: Report of a Case and Review of the Literature

Abstract

The diagnosis of granular acute lymphoblastic leukemia (ALL) can be problematic as the cytoplasmic granules found in many blast cells may mimic those seen in acute myelogenous leukemia (AML). This rare variant of B-cell ALL is more commonly diagnosed in children, but may occur in adults. We report a case of granular B-ALL in a 56-year-old female and review the literature.

B lymphoblastic leukemia with granules mimicking acute myeloid leukemia in a 4 years female child

“…Cytoplasmic granules are one of the key morphologic features differentiating AML from ALL. These granules in AML are fused lysosomes and contain lysosomal enzymes and crystalline inclusions but are rarely present in adult ALL cells [5] . In pediatric cases of ALL, these granules present at a higher frequency.…”

Case report of granular acute lymphoblastic leukemia and review of the literature

“…Cytoplasmic granules are one of the key morphologic features differentiating acute myeloid leukemia (AML) from acute lymphoblastic leukemia (ALL). These granules in AML are fused lysosomes and contain lysosomal enzymes and crystalline inclusions, but are rarely present in adult ALL cells . The morphology of these granules has been characterized as membrane bound vesicles and tubular arrays .…”

“…These granules in AML are fused lysosomes and contain lysosomal enzymes and crystalline inclusions, but are rarely present in adult ALL cells. 3 The morphology of these granules has been characterized as membrane bound vesicles and tubular arrays. 4 In pediatric cases of ALL, granules present at a higher frequency.…”

Granular acute lymphoblastic leukemia: A case report and literature review

“…Note: After we submitted the manuscript, we noticed an additional case report of precursor B granular ALL by Fulcher et al We included this paper in our reference (Ref. 15).…”