{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:54:57Z","timestamp":1791028497046,"version":"4.1.0"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T00:00:00Z","timestamp":1790985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diagnostic Cytopathology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Acute promyelocytic leukemia (APL) is a hematologic emergency in which prompt diagnosis is essential to reduce early hemorrhagic mortality. Although oral manifestations are well recognized in acute myeloid leukemia, gingival infiltration is distinctly uncommon in APL, and concomitant central nervous system (CNS) involvement at presentation is exceptionally rare. As gingival lesions may be sampled during their diagnostic evaluation, recognition of characteristic cytomorphology on fine\u2010needle aspiration cytology (FNAC) can provide an early clue to the underlying hematologic malignancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>\n                      A 30\u2010year\u2010old man presented with excessive post\u2010tooth\u2010extraction bleeding, diffuse gingival enlargement, and left facial palsy. FNAC of the gingival swelling demonstrated scattered abnormal hypergranular promyelocytes with folded nuclei, multiple Auer rods, and occasional faggot cells in a hemorrhagic background, strongly suggestive of APL. Subsequent peripheral blood flow cytometry, bone marrow examination, and molecular testing confirmed\n                      <jats:italic>PML::RARA<\/jats:italic>\n                      \u2010positive APL. Cerebrospinal fluid cytology and flow cytometry established concurrent CNS involvement. Treatment with all\u2010trans retinoic acid and arsenic trioxide resulted in hematologic remission and complete resolution of the gingival enlargement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This case highlights the diagnostic value of gingival FNAC in the rapid identification of uncommon extramedullary presentations of APL. Knowledge of the characteristic cytomorphologic features facilitates early diagnosis and timely initiation of the life\u2010saving differentiation therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dc.70216","type":"journal-article","created":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T11:25:32Z","timestamp":1791026732000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fine\u2010Needle Aspiration Cytology of Gingival Acute Promyelocytic Leukemia: Cytomorphologic Clues to an Unusual Extramedullary Presentation"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7368-0323","authenticated-orcid":false,"given":"Aravind","family":"Radhakrishnan","sequence":"first","affiliation":[{"name":"Department of Cytology and Gynecological Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5466-879X","authenticated-orcid":false,"given":"Kaustabh","family":"Adhikari","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology and Medical Oncology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2980-8914","authenticated-orcid":false,"given":"Praveen","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0791-9426","authenticated-orcid":false,"given":"Nabhajit","family":"Mallik","sequence":"additional","affiliation":[{"name":"Department of Hematology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9495-9789","authenticated-orcid":false,"given":"Arihant","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology and Medical Oncology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2159-4325","authenticated-orcid":false,"given":"Parikshaa","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Cytology and Gynecological Pathology Postgraduate Institute of Medical Education and Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,3]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"WHO Classification of Tumours: Hematolymphoid Tumors","author":"WHO Classification of Tumours Editorial Board","year":"2022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"crossref","DOI":"10.3390\/cancers15133477","article-title":"The Coagulopathy of Acute Promyelocytic Leukemia: An Updated Review of Pathophysiology, Risk Stratification, and Clinical Management","volume":"15","author":"Hermsen J.","year":"2023","journal-title":"Cancers"},{"issue":"6","key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1038\/s41408-021-00514-3","article-title":"Acute Promyelocytic Leukemia Current Treatment Algorithms","volume":"11","author":"Yilmaz M.","year":"2021","journal-title":"Blood Cancer Journal"},{"issue":"3","key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3109\/10428199909058422","article-title":"Extramedullary Disease in Acute Promyelocytic Leukemia","volume":"33","author":"Evans G. 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S.","year":"2012","journal-title":"Open Journal of Stomatology"},{"key":"e_1_2_9_9_1","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2016-217457","article-title":"Acute Promyelocytic Leukaemia: Looking Through \u2018Gums\u2019","volume":"2016","author":"Jain A.","year":"2016","journal-title":"BMJ Case Reports"},{"issue":"2","key":"e_1_2_9_10_1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.4103\/injms.injms_26_23","article-title":"Gingival Hypertrophy in Acute Promyelocytic Leukemia\u2014A Rare Clinical Encounter","volume":"14","author":"Shastri A.","year":"2023","journal-title":"Indian Journal of Medical Specialities"},{"issue":"6","key":"e_1_2_9_11_1","doi-asserted-by":"crossref","DOI":"10.1093\/omcr\/omag097","article-title":"Acute Promyelocytic Leukaemia Presenting With Gingival Hypertrophy: An Atypical Oral Presentation","volume":"2026","author":"Antiri E. 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