Figure 3.
NPM-immunostaining–based approach to molecular-cytogenetic study of AML. AML cases can be simply subdivided by immunohistochemistry in 2 groups (ie, expressing nucleus-restricted NPM [NPMc–] or cytoplasmic NPM [NPMc+]; both figures were captured with an Olympus 100×/1.3 UPlanFl oil objective). The arrow in the NPMc– panel indicates the expected cytoplasmic positivity of a mitotic figure. Molecular studies for recurrent genetic abnormalities can be avoided in NPMc+ AML since the 2 events are mutually exclusive. For the same reason, mutational analysis of NPM is unnecessary in patients with NPMc– AML. Cytogenetics and other molecular studies should be performed in both NPMc+ and NPMc– patients with AML for diagnostic and investigational purposes.

NPM-immunostaining–based approach to molecular-cytogenetic study of AML. AML cases can be simply subdivided by immunohistochemistry in 2 groups (ie, expressing nucleus-restricted NPM [NPMc] or cytoplasmic NPM [NPMc+]; both figures were captured with an Olympus 100×/1.3 UPlanFl oil objective). The arrow in the NPMc panel indicates the expected cytoplasmic positivity of a mitotic figure. Molecular studies for recurrent genetic abnormalities can be avoided in NPMc+ AML since the 2 events are mutually exclusive. For the same reason, mutational analysis of NPM is unnecessary in patients with NPMc AML. Cytogenetics and other molecular studies should be performed in both NPMc+ and NPMc patients with AML for diagnostic and investigational purposes.

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