ABSTRACT
A 23-year-old male presented with pulmonary tuberculosis and swelling of both lower limbs. He was put on antitubercular treatment. Hemogram showed mild anemia and Pseudo Pelger-huet cells. The bone marrow (BM) examination showed 52% promyelocytes with regular round to oval nuclei, few granules and were positive for CD13 and CD33, and negative for HLA-DR. Cytogenetic analysis of the BM aspirate revealed an apparently balanced t(11;17)(q23;q21). Final diagnosis rendered was acute promyelocytic leukemia (APL) with t(11;17)(q23;q21); ZBTB16/RARA. APL is a distinct subtype of acute myeloid leukemia. The variant APL with t(11;17)(q23;q21) cases that are associated with the ZBTB16/RARA fusion gene have been reported as being resistant to all-trans-retinoic acid (ATRA). Therefore, differential diagnosis of variant APL with t(11;17)(q23;q12) from classical APL with t(15;17)(q22;q12); PML-RARA is very important. Here we have discussed the importance of distinct morphology of variant APL and also significance of rare presentation with tuberculosis.
Subject(s)
Humans , Male , Young Adult , Anemia , Bone Marrow , Cytogenetic Analysis , Diagnosis, Differential , Granulocyte Precursor Cells , HLA-DR Antigens , Leukemia, Myeloid, Acute , Leukemia, Promyelocytic, Acute , Lower Extremity , Tretinoin , Tuberculosis , Tuberculosis, PulmonaryABSTRACT
Hepatic tuberculosis particularly in the absence of military tuberculosis is rare. It can occur as a primary case or due to reactivation of an old tubercular focus. We report case of a 24 year old married female who died of primary hepatic tuberculosis. She had no evidence of tuberculosis elsewhere. Appropriate treatment initiated early can result in marked recovery whereas failure to recognize this entity can prove to be fatal.