Pathology · Hematological Malignancies (Leukemias, Lymphomas, Myeloma)

A 40-year-old woman has fatigue and easy bruising. Bone marrow shows a mixture of myeloblasts and monoblasts along with numerous eosinophils containing large basophilic-purple granules. Cytogenetics reveal inv(16)(p13;q22). Which fusion transcript is present?

  • A PML-RARA
  • B CBFB-MYH11
  • C RUNX1-RUNX1T1
  • D BCR-ABL1
Correct answer: B. CBFB-MYH11

Explanation

inv(16) fuses CBFB at 16q22 with MYH11 at 16p13, producing the core binding factor AML subtype with abnormal eosinophils bearing large basophilic granules (formerly M4eo). RUNX1-RUNX1T1 corresponds to t(8;21), the other core binding factor lesion, and PML-RARA to t(15;17); both lack the dysplastic eosinophils that are the morphologic signature killing those distractors here.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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