Color Atlas of Hematology - Practical Microscopic and Clinical ...

126Abnormalities of the White Cell Seriespathologies and can develop to the extent of being termed “chronic basophilicleukemia.” In the very rare acute basophilic leukemia, the cells inthe basophilic granulocyte lineage mature in the bone marrow only to thestage of promyelocytes, giving a picture similar to type M 3 AML (p. 98).Being an expression of idiopathic disturbance of bone marrow function,elevated basophil counts are a relatively constant phenomenon in myeloproliferativesyndromes (in addition to the specific signs of these diseases),especially in CML. Acute basophilic leukemia is extremely rare; in thiscondition, some of the dedifferentiated blasts contain more or less basophilicgranules.The tissue-bound analogs of the segmented basophils, the tissue mastcells, can show benign or malignant cell proliferation, including the (extremelyrare) acute mast cell leukemia (Table 21).Table 21cellsDifferent forms of benign and malignant proliferation of tissue mastClinical picture Clinical diagnosis EvidenceIn childhood, solitary ormultiple skin nodules,some brownish Sometimes transitionDiffuse brownish papules,with urticaria on irritationHyperpigmented spots,papules and/or dermographism;histaminesymptoms: flushing, headache,pruritus, abdominalspasms, shockMalignant transformation,possibly with osteolysis,enlarged lymph nodes,splenomegaly, hepatomegalyMigration of leukemic cellsto peripheral bloodLocalized mastocytosisUrticaria pigmentosaSystemic mastocytosisMalignant mastocytosis*Acute mast cellleukemiaHistologyTypical clinicalpictureHistologyHistologyCBC (bone marrow)* May occur de novo without preceding stages and without skin involvement.