A 45-year-old man was referred for molecular testing to confirm the morphological suspicion of APL. Fever and easy fatigability were the only presenting symptoms. Morphological features were similar to case 1, as highlighted by the presence of abnormal promyelocytes containing round nuclei with regular nuclear contours, abundant granulated cytoplasm and a lack of Auer rods. In contrast to classical APL cases maturing myeloid cells were also present along with a few hypolobated or Pelger-like neutrophils. Dual fusion FISH for PML-RARA was negative, but the break-apart probe revealed RARA variant translocation. ZBTB16-RARA fusion was confirmed by PCR. RT-qPCR showed a baseline mean Ct value of 21.64. Although the patient was started on induction with ATO, he was lost to follow up subsequently.