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Peripheral smear from a patient with the typical hypergranular type of acute promyelocytic leukemia (APL)

Peripheral smear from a patient with the typical hypergranular type of acute promyelocytic leukemia (APL)
The white cell count in this type of APL is usually low with only a few circulating malignant promyelocytes. The abnormal promyelocytes frequently have bi-lobed or dumbbell shaped nuclei with granular cytoplasm. They can be difficult to recognize due to their scarcity, but when seen they should immediately raise the possibility of APL.
Graphic 82863 Version 1.0