The Hand Mirror Image: Which is the Lineage in the End?

According to the World Health Organization (WHO) 2016 classification, acute promyelocytic leukemia (APL) is placed in category of AML with recurrent cytogenetic abnormalities. Cytogenetic confirmation reciprocal translocation t(15:17) essential criteria for diagnosis this entity. However, these tests may have a significant time delay and it usually characteristic morphology abnormal promyelocytes which helps pick up early alert clinician initiate treatment promptly. The two variants commonly described are hypergranular variant (M3v) forms, but knowledge other rarer morphological APL becomes crucial certain situations hematopathologist. To highlight phenomenon, we describe case report 9-year-old female who presented hand mirror promyelocytes.