Poikayil et al reported a case of concurrent leukemia cutis and NLK as the initial presentation of MPAL, which is extremely rare.6Our patient too was a case of MPAL showing positivity for myeloid markers (cluster of differentiation CD117, CD13, and myeloperoxidase) and lymphoid markers (CD2, CD3, and CD7). Here, ANPEP is linked to mixed phenotype acute leukemia.