El Bayed Sakalli H*, Ouazzani Touhami K, Oukkache B
Introduction: Auer rods are crystalline inclusions, pathognomic of myeloid differentiation of the leukemic blasts. Their presence in maturing myeloid cells and monocytes is rare. In this study, we report a rare and uncommon case of acute biphenotypic leukemia with Auer rods in fagot present in the mature neutrophils. Case report: 21 years old men admitted at the hospital with a tumor syndrome, the hem gram detected a leukocytosis at 79 500/μl with 96% blasts, a normochromic normocytic anemia at 8.3 g/dl and a thrombocytopenia at 40 000/ul. The myelogram revealed a rich marrow of 92% of heterogeneous size blasts with a cross linked chromatin nucleus and basophilic cytoplasm.The neutrophils with mono or bilobed nucleus characterized by the presence of Auer bodies in fagot. The immunophenotyping showed acute biphenotypic leukemia and the medullary karyotype showed a trisomy 4, a deletion of the chromosome 16 in q22, the translocation. Discussion: The presence of Auer rods in neutrophils is an uncommon phenomenon, evocative of nucleo cytoplasmic asynchronism, where the nuclear maturation has occurred, their presence is linked to a favorable prognosis of the disease. Auer rods in fagot are characteristic of acute promyelocytic leukemia but as illustrated by our patient, they cannot be considered specific It has been observed that their presence in neutrophils is linked, in most cases, to acute myeloblastic leukemia with acute promyelocytic leukemia and acute myeloblastic leukaemia with maturation M3 and rarely M1 and myelodysplastic syndrome.
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