Question

A 68-year-old man presents with bleeding. Peripheral smear shows a “faggot cell.” Which translocation is associated?

• A. t(15;17)
• B. t(14;18)
• C. t(11;14)
• D. t(8;21)

Hint:

Faggot cells + bleeding/DIC = APL; translocation = t(15;17).

Answer 1

The Correct Option is A

Step 1: Understanding the Question:
The term "faggot cell" is a specific pathological buzzword for cells seen in Acute Promyelocytic Leukemia (APL, AML-M3).
Step 2: Detailed Explanation:

Acute Promyelocytic Leukemia (APL): This is a subtype of AML characterized by the proliferation of abnormal promyelocytes.

Faggot Cells: These are promyelocytes that contain bundles or clusters of numerous Auer rods (resembling a bundle of sticks or "faggots"). Auer rods are composed of fused lysosomes and peroxidase.

Translocation t(15;17): APL is defined by the fusion of the Retinoic Acid Receptor Alpha (RARA) gene on chromosome 17 and the Promyelocytic Leukemia (PML) gene on chromosome 15.

Clinical Emergency: APL is a medical emergency because the granules in the cells can trigger severe Disseminated Intravascular Coagulation (DIC).

Treatment: It is uniquely sensitive to ATRA (All-Trans Retinoic Acid) and Arsenic Trioxide, which force the malignant cells to differentiate.

Step 3: Final Answer:
The "faggot cells" of AML-M3 are characteristically associated with the t(15;17) PML-RARA translocation.