Background: As a rare heterogeneous kind of acute leukemia, mixed-phenotype acute leukemia (MPAL) co-expresses more than one cell lineage and could contain bilineal, biphenotypic, or a combination. MPAL is classified as T/myeloid, B/myeloid, B/T-lymphoid, and trilineage B/T/myeloid.
Method: Here, we report a rare case of T/Myeloid bilineage mixed-phenotype acute leukemia with basophilia.
Result: The puzzling morphological features are due to two distinct kinds of blasts have put hematologists into a dilemma. The diagnosis of T/myeloid MPAL with basophilia was established based on integrated diagnostics.
Conclusions: To date, no case of a patient diagnosed with T/Myeloid bilineage MPAL with basophilia has been reported. The case focuses on the importance of an integrated diagnostic work-up, with a challenging morphological presentation and crucial role for flow cytometry.