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Abstract
PURPOSE OF REVIEW Myeloid sarcoma; also known as granulocytic sarcoma and chloroma, often occurs concomitantly with AML, and rarely without bone marrow involvement. In this article, we review the recent literature on myeloid sarcoma, focusing on treatment approach for this rare disease, and addressing the prognostic and therapeutic role of molecular and cytogenetic aberrations. RECENT FINDINGS Molecular testing and cytogenetics are important adjunct to conventional diagnostic methods. The significance of cytogenetic and molecular abnormalities in myeloid sarcoma is not completely established, but testing for targetable mutations on myeloid sarcoma cells is feasible, imperative, and may guide treatment decisions. Outcomes in myeloid sarcoma largely depend on the background of its development. Almost all patients with myeloid sarcoma eventually develop AML typically in a short period after its diagnosis; therefore, remission induction treatment using AML type chemotherapy has been the standard of care. Postremission therapy is controversial; allogenic SCT, radiotherapy or consolidation chemotherapy should be considered according to patient risk. SUMMARY Further research is required to understand the nature of myeloid sarcoma, and inclusion of patients with this condition in clinical trials should be considered to better identify the best diagnostic, prognostic, and therapeutic approach in managing this rare disease.
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2
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Dalland JC, Meyer R, Ketterling RP, Reichard KK. Myeloid Sarcoma With CBFB-MYH11 Fusion (inv(16) or t(16;16)) Prevails in the Abdomen. Am J Clin Pathol 2020; 153:333-341. [PMID: 31671434 DOI: 10.1093/ajcp/aqz168] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Myeloid sarcoma with CBFB-MYH11 fusion may be enriched in abdominal sites. The clinicopathologic features of 11 cases are reported. METHODS We collected clinical features, morphology, immunophenotype, and bone marrow (BM) involvement of myeloid sarcoma cases with CBFB-MYH11 fusion. RESULTS Eleven of 29 total myeloid sarcoma cases were CBFB-MYH11 positive and all 11 involved abdominal sites. The blastic infiltrate was associated with eosinophils in four of 11 cases and plasmacytoid dendritic cell (pDC) nodules in four of six cases. CD34, CD117, and myeloperoxidase were expressed in eight of nine, 10 of 10, and 10 of 10 cases, respectively. Ten of 10 cases showed no BM involvement. CONCLUSIONS Our current series, combined with a literature review, identifies a compelling series of 31 (94%) of 33 cases of myeloid sarcoma with CBFB-MYH11 fusion showing a marked predilection for abdominal sites. In addition, the lack of obvious associated eosinophils, presence of pDC nodules, and lack of concurrent BM involvement suggest that "myeloid sarcoma with CBFB-MYH11 fusion" may represent a unique phenomenon.
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Affiliation(s)
- Joanna C Dalland
- Department of Laboratory Medicine and Pathology, Divisions of Hematopathology, Rochester, MN
| | - Reid Meyer
- Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN
| | - Rhett P Ketterling
- Department of Laboratory Medicine and Pathology, Divisions of Hematopathology, Rochester, MN
- Laboratory Genetics and Genomics, Mayo Clinic, Rochester, MN
| | - Kaaren K Reichard
- Department of Laboratory Medicine and Pathology, Divisions of Hematopathology, Rochester, MN
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3
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Cunningham I, Worthley D. Leukemia in gastrointestinal organs as cause of treatment failure: 378 cases analyzed. Am J Hematol 2018; 93:1327-1336. [PMID: 30105897 DOI: 10.1002/ajh.25250] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 07/31/2018] [Accepted: 08/06/2018] [Indexed: 12/19/2022]
Abstract
Leukemia growing as tumors in gastrointestinal organs is an under-investigated cause of treatment failure and death. These present with symptoms often mistaken for common toxicities but may grow large before symptoms. To synthesize experience available only in case reports, 378 were analyzed. Invasive and metastatic behavior typical of solid GI tumors was revealed even when marrow was uninvolved. Within 3 months of diagnosis, 33% had died, 47% within 1 year. Survivals of 4 to 18 years after involvement suggest cure is possible. Evidence is presented that combined local and systemic therapy has successfully treated GI leukemic tumors when identified early.
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Affiliation(s)
- Isabel Cunningham
- Columbia University College of Physicians and Surgeons, New York, New York
| | - Daniel Worthley
- Cancer Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
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4
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Longo R, Dorvaux V, Chatelain E, Quétin P, Plastino F, Eid N, Marcon N, Hennequin L, Campitiello M. Peritoneal Myeloid Sarcoma in a Patient Treated for a Testicular Seminoma. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:763-766. [PMID: 29955031 PMCID: PMC6055577 DOI: 10.12659/ajcr.910434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Myeloid sarcoma is a rare extramedullary soft tissue neoplasm composed of myeloblastic cells, usually associated to hematologic tumor disorders and a poor prognosis. Its diagnosis is very difficult as radiological images are not specific. Histology and immunohistochemistry are necessary for an accurate diagnosis. CASE REPORT We report the case of 46-year-old, Caucasian, non-smoker male, treated in 2014 by orchiectomy and systemic chemotherapy for a stage IIB testicular seminoma. Considering the rapid increase of lactate dehydrogenase (LDH) levels without any evident medical reason, a computed tomography/positron emission tomography (CT/PET) scan was performed and revealing a diffuse, nodular, peritoneal tumor infiltration associated with multiple mesenteric and mediastinal adenopathies. Laparoscopy confirmed a diffuse tumor infiltration of the peritoneum. Histology and immunohistochemistry were consisted with the diagnosis of a myeloid monoblastic sarcoma. Cytology of bone marrow documented an monocytic acute myeloid leukemia. The patient started a systemic induction chemotherapy with high dose cytarabine and idarubicin that was complicated by an infectious pneumonia and colitis, and a grade IV thrombocytopenia leading to a brain subdural hemorrhage and quickly to patient's death. CONCLUSIONS We describe a rare, peritoneal, myeloid sarcoma in a young patient who had been treated by systemic chemotherapy for testicular seminoma 4 years earlier. The patient was clinically asymptomatic and presented only elevated LDH levels without any evident clinical reason. Considering the persistence of this biochemical abnormality, more investigations were performed leading to a diagnosis of peritoneal myeloid sarcoma associated with monocytic acute myeloid leukemia, probably secondary to the past chemotherapy.
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Affiliation(s)
- Raffaele Longo
- Division of Medical Oncology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Véronique Dorvaux
- Division of Hematology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Eric Chatelain
- Division of Digestive Surgery, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Philippe Quétin
- Division of Radiotherapy, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Francesca Plastino
- Division of Medical Oncology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Nada Eid
- Division of Medical Oncology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Nathalie Marcon
- Division of Pathology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Laurent Hennequin
- Division of Radiodiagnostics and Medical Imaging, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
| | - Marco Campitiello
- Division of Medical Oncology, Mercy Hospital, Metz-Thionville Regional Hospital Center, Ars-Laquenexy, France
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5
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Kashofer K, Gornicec M, Lind K, Caraffini V, Schauer S, Beham-Schmid C, Wölfler A, Hoefler G, Sill H, Zebisch A. Detection of prognostically relevant mutations and translocations in myeloid sarcoma by next generation sequencing. Leuk Lymphoma 2017. [PMID: 28633614 PMCID: PMC5743000 DOI: 10.1080/10428194.2017.1339879] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Karl Kashofer
- a Institute of Pathology , Medical University of Graz , Graz , Austria
| | - Max Gornicec
- b Division of Hematology , Medical University of Graz , Graz , Austria
| | - Karin Lind
- b Division of Hematology , Medical University of Graz , Graz , Austria
| | | | - Silvia Schauer
- a Institute of Pathology , Medical University of Graz , Graz , Austria
| | | | - Albert Wölfler
- b Division of Hematology , Medical University of Graz , Graz , Austria
| | - Gerald Hoefler
- a Institute of Pathology , Medical University of Graz , Graz , Austria
| | - Heinz Sill
- b Division of Hematology , Medical University of Graz , Graz , Austria
| | - Armin Zebisch
- b Division of Hematology , Medical University of Graz , Graz , Austria
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6
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Xiao D, Shi Y, Fu C, Jia J, Pan Y, Jiang Y, Chen L, Liu S, Zhou W, Zhou J, Tao Y. Decrease of TET2 expression and increase of 5-hmC levels in myeloid sarcomas. Leuk Res 2016; 42:75-9. [PMID: 26811000 DOI: 10.1016/j.leukres.2016.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 01/06/2016] [Accepted: 01/08/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Myeloid sarcoma is a tumor mass that consists of myeloblasts or immature myeloid cells at an extramedullary site. Pathological diagnosis is very difficult based on morphology if systemic signs of disease are absent. The subtype of myeloid sarcoma is also minimally identifiable in the histological picture. FINDINGS We investigated 18 paraffin-embedded myeloid sarcoma samples, and our immunohistochemical data confirmed the relevance of some key markers for the diagnosis and subclassification of myeloid sarcoma. CD34 was found as a marker in 67% of the myeloid sarcoma cases, and CD34 was positive in all immature types of myeloid sarcoma. CD68 was found in 83% of the myeloid sarcoma cases, but CD68 was most identified in the differentiated type of myeloid sarcoma. Myeloperoxidase (MPO) was positive in all myeloid sarcomas. Notably, the reactivity of MPO in the blastic subtype was much lower in myeloid sarcomas. CD117 reactivity was found in 67% of myeloid sarcomas. Ten-eleven translocation 2 (TET2) protein exhibited significant negative reactivity in 88% of the cases, and 5-methylcytosine (5-hmC) was significantly positive in the nucleus in 100% of the cases. CONCLUSIONS Our findings indicated that an immunohistochemical panel that included MPO, CD68 and CD34 could be used for the detection of blastic, differentiated and immature types of myeloid sarcoma. Changes in novel epigenetic regulators, including the loss of TET2 and gain of 5-hmC, as characteristics of myeloid malignancies may be useful novel markers of myeloid sarcoma.
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Affiliation(s)
- Desheng Xiao
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, China; Department of Pathology, School of basic medicine, Central South University, Changsha, Hunan 410078, China.
| | - Ying Shi
- Cancer Research Institute, Central South University, Changsha, Hunan 410078 China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Hunan 410078 China; Key Laboratory of Carcinogenesis, National Health and Family Planning Commission, Hunan 410078 China.
| | - Chunyan Fu
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, China; Department of Pathology, School of basic medicine, Central South University, Changsha, Hunan 410078, China.
| | - Jiantao Jia
- Cancer Research Institute, Central South University, Changsha, Hunan 410078 China; Changzhi School of Medicine, Changzhi, Shanxi 046000, China.
| | - Yu Pan
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, China; Department of Pathology, School of basic medicine, Central South University, Changsha, Hunan 410078, China.
| | - Yiqun Jiang
- Cancer Research Institute, Central South University, Changsha, Hunan 410078 China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Hunan 410078 China; Key Laboratory of Carcinogenesis, National Health and Family Planning Commission, Hunan 410078 China.
| | - Ling Chen
- Cancer Research Institute, Central South University, Changsha, Hunan 410078 China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Hunan 410078 China; Key Laboratory of Carcinogenesis, National Health and Family Planning Commission, Hunan 410078 China.
| | - Shuang Liu
- Center for Medicine Research, Xiangya Hospital, Central South University, Changsha, Hunan 410008 China.
| | - Wen Zhou
- Cancer Research Institute, Central South University, Changsha, Hunan 410078 China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Hunan 410078 China; Key Laboratory of Carcinogenesis, National Health and Family Planning Commission, Hunan 410078 China.
| | - Jianhua Zhou
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, China; Department of Pathology, School of basic medicine, Central South University, Changsha, Hunan 410078, China.
| | - Yongguang Tao
- Department of Pathology, Xiangya Hospital, Central South University, Changsha, Hunan 410078, China; Cancer Research Institute, Central South University, Changsha, Hunan 410078 China; Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Hunan 410078 China; Key Laboratory of Carcinogenesis, National Health and Family Planning Commission, Hunan 410078 China.
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7
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Abstract
OBJECTIVES This session of the 2013 Society of Hematopathology/European Association for Haematopathology workshop focused on extramedullary manifestations of myeloid neoplasms. METHODS We divided the submitted cases into four subgroups: (1) isolated myeloid sarcoma (MS); (2) MS with concurrent acute myeloid leukemia (AML), with a focus on karyotypic and molecular findings; (3) extramedullary relapse of AML, including relapse in the posttransplant setting; and (4) blast phase/transformation of a myeloproliferative neoplasm or chronic myelomonocytic leukemia. RESULTS Establishing a diagnosis of isolated MS requires a high index of suspicion and use of immunophenotypic methods. Recurrent cytogenetic abnormalities or gene mutations that occur in MS mirror those known to occur in AML. CONCLUSIONS In the era of targeted therapy and sophisticated risk stratification, every attempt must be made to perform a complete workup on MS cases (or concurrent AML) since the diagnosis of MS, in itself, is no longer adequate for patient management. Cases of blastic plasmacytoid dendritic cell neoplasm were also included and discussed in this session.
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Affiliation(s)
- Carla S. Wilson
- Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque
| | - L. Jeffrey Medeiros
- The Department of Hematopathology, University of Texas MD Anderson Cancer Center, Houston
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8
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Kurdoğlu B, Oztemel A, Barış E, Sengüven B. Primary oral myeloid sarcoma: Report of a case. J Oral Maxillofac Pathol 2014; 17:413-6. [PMID: 24574662 PMCID: PMC3927345 DOI: 10.4103/0973-029x.125209] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Myeloid sarcoma is defined as a tumor mass of immature myeloid cells that may be observed in a variety of locations including bone, skin, lymph nodes and soft tissues. However, oral involvement of myeloid sarcoma is extremely rare. These tumors are considered as specific lesions of acute myeloid leukemia. We present a case of a myeloid sarcoma of the upper vestibular gingiva in a 29-year-old woman who has no hematologic disease history. Multiple metastases were found in floor of the nasal cavity, left breast, and left lacrimal gland 12 months after primary diagnosis.
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Affiliation(s)
- Başak Kurdoğlu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Akın Oztemel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Emre Barış
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Burcu Sengüven
- Department of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara, Turkey
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9
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Baikaidi M, Chung SS, Tallman MS, Damon LE, Walker AR, Marcucci G, Sholi AM, Morris GJ. A 75-year-old woman with thoracic spinal cord compression and chloroma (granulocytic sarcoma). Semin Oncol 2013. [PMID: 23206848 DOI: 10.1053/j.seminoncol.2012.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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10
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Yonal I, Kayar Y, Nazligul E, Yenerel MN, Kalayoglu-Besisik S. Leukemic ascites as an initial presentation of acute myelomonocytic leukemia with inversion of chromosome 16. Ann Saudi Med 2013; 33:197-8. [PMID: 23563011 PMCID: PMC6078620 DOI: 10.5144/0256-4947.2013.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Ipek Yonal
- Department of Internal Medicine, Division of Hematolgy, Istanbul, Turkey
- Correspondence: Dr. Ipek Yonal Department of Internal Medicine, Division of Hematolgy, Istanbul Universitesi Istanbul Tip Fakultesi, Ic Hastaliktari ABD, Hematolji BD Istanbul 34104 Turkey
| | - Yusuf Kayar
- Department of Internal Medicine, Division of Hematolgy, Istanbul, Turkey
| | - Esra Nazligul
- Department of Internal Medicine, Division of Hematolgy, Istanbul, Turkey
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11
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Shimizu H, Saitoh T, Hatsumi N, Takada S, Yokohama A, Handa H, Jimbo T, Sakura T, Tsukamoto N, Murakami H, Miyawaki S, Nojima Y. Clinical significance of granulocytic sarcoma in adult patients with acute myeloid leukemia. Cancer Sci 2012; 103:1513-7. [PMID: 22568487 DOI: 10.1111/j.1349-7006.2012.02324.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Revised: 04/27/2012] [Accepted: 04/30/2012] [Indexed: 11/27/2022] Open
Abstract
To investigate the clinical significance of granulocytic sarcoma (GS) in adults with acute myeloid leukemia (AML), 434 consecutive patients with AML were analyzed retrospectively. Forty-five patients (10.4%) with GS at diagnosis were younger (P < 0.001), presented with higher white blood cell counts (P = 0.03) and were more likely to conform to French-American-British M4 (P = 0.001) and M5 (P = 0.045) classifications than those without GS. In contrast, no significant difference in frequency of cytogenetic abnormalities was found between the GS and non-GS groups. Treatment outcomes in 260 patients (40 with GS) who underwent intensive chemotherapy, excluding patients with acute promyelocytic leukemia, were investigated. Complete remission rates did not differ significantly between the GS and non-GS groups (75.0% vs 79.1%; P = 0.192, respectively) or the 5-year overall survival (OS) rates (39.9% vs 38.7%; P = 0.749, respectively). However, the GS group had a significantly higher relapse rate than the non-GS group (74.2% vs 55.3%; P = 0.048) and a significantly lower 5-year disease-free survival rate (8.2% vs 25.7%, respectively; P = 0.005). When considered together with the results of multivariate analysis, which identified the presence of GS as an independent predictor for disease-free survival time, these findings indicate that GS might identify a high-risk subset of patients with AML.
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Affiliation(s)
- Hiroaki Shimizu
- Leukemia Research Center, Saiseikai Maebashi Hospital, Gunma, Japan.
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12
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Messager M, Amielh D, Chevallier C, Mariette C. Isolated granulocytic sarcoma of the pancreas: a tricky diagnostic for primary pancreatic extramedullary acute myeloid leukemia. World J Surg Oncol 2012; 10:13. [PMID: 22248364 PMCID: PMC3283461 DOI: 10.1186/1477-7819-10-13] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 01/16/2012] [Indexed: 12/22/2022] Open
Abstract
We report two clinical cases of primary granulocytic sarcoma of the pancreas that were diagnosed on the surgical specimen. Atypical clinical and morphological presentations may have lead to pretherapeutic biopsies of the pancreatic mass in order to indicate primary chemotherapy. Literature review of this rare clinical presentation may help physicians to anticipate diagnostic and therapeutic strategies.
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Affiliation(s)
- Mathieu Messager
- Department of Digestive and Oncological Surgery, Centre Régional et Universitaire de Lille, Place de Verdun, 59037 Lille cedex, France
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13
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Avni B, Rund D, Levin M, Grisariu S, Ben-Yehuda D, Bar-Cohen S, Paltiel O. Clinical implications of acute myeloid leukemia presenting as myeloid sarcoma. Hematol Oncol 2011; 30:34-40. [PMID: 21638303 DOI: 10.1002/hon.994] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2011] [Accepted: 03/15/2011] [Indexed: 12/18/2022]
Abstract
In this retrospective study, we aim to analyze the characteristics, treatments, and overall survival of all patients presenting with isolated myeloid sarcoma (MS) or MS with concomitant acute myeloid leukemia (AML) compared with all patients with AML, treated during the same period. We identified patients with AML with or without MS at diagnosis, presenting to our medical center between the years 1990 and 2005. There was no statistically significant difference between the groups regarding gender, age, cytogenetic risk groups, rate of complete remission, number of cycles of chemotherapy needed to achieve complete remission, and rate of first relapse. The time to death in the MS group was not significantly different (p = 0.60) from the AML group, and radiotherapy did not affect the median time to death. Transplantation prolonged survival in both groups (p = 0.018 and p < 0.0001, respectively). Patients with MS at diagnosis might benefit from upfront aggressive treatment with hematopoietic stem cell transplantation.
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Affiliation(s)
- Batia Avni
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
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14
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Zhang XH, Zhang R, Li Y. Granulocytic sarcoma of abdomen in acute myeloid leukemia patient with inv(16) and t(6;17) abnormal chromosome: case report and review of literature. Leuk Res 2010; 34:958-61. [PMID: 20116851 DOI: 10.1016/j.leukres.2010.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 01/08/2010] [Accepted: 01/09/2010] [Indexed: 12/18/2022]
Abstract
Granulocytic sarcoma (GS) is composed of immature granulocytic precursors and is usually found in acute myeloid leukemia (AML) patients with t(8;21). Inv(16) is rarely associated with GS comparing with t(8;21) leukemia. Here we describe an abdominal GS patient in AML-M2 with acquired translocation between chromosomes 6 and 17 and inv (16). We have also summarized 20 reported GS cases with inv(16) and found that chloroma was most often found in abdominal lesions. Intestine maybe a tissue specific target for the expression of inv(16) leukemia. Complete physical examination and molecular diagnosis are necessary for AML patients to benefit from the diagnosis and therapeutic strategy.
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Affiliation(s)
- Xu-Hui Zhang
- Jiangsu Institute of Hematology, Key Laboratory of Thrombosis and Hemostasis of Ministry of Health, the First Affiliated Hospital of Soochow University, Soochow, Jiangsu, PR China.
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15
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Ukkola-Pons E, Weber-Donat G, Minvielle F, Bonardel G, Baccialone J, Jeanbourquin D, Teriitehau C. [Gallbladder chloroma: a case report]. JOURNAL DE RADIOLOGIE 2010; 91:239-240. [PMID: 20389274 DOI: 10.1016/s0221-0363(10)70032-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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16
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Göhring G, Erlacher M, van Buiren M, Jüttner E, Niemeyer CM, Schlegelberger B. Mesenteric chloroma with t(16;16) followed by acute myelomonocytic leukemia with clonal evolution. ACTA ACUST UNITED AC 2007; 179:162-4. [DOI: 10.1016/j.cancergencyto.2007.08.016] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Accepted: 08/31/2007] [Indexed: 11/30/2022]
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17
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Mallo M, Espinet B, Salido M, Ferrer A, Pedro C, Besses C, Pérez-Vila E, Serrano S, Florensa L, Solé F. Gain of multiple copies of the CBFB gene: a new genetic aberration in a case of granulocytic sarcoma. ACTA ACUST UNITED AC 2007; 179:62-5. [DOI: 10.1016/j.cancergencyto.2007.07.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Revised: 07/27/2007] [Accepted: 07/30/2007] [Indexed: 11/26/2022]
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18
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Monma F, Nishii K, Shiga J, Sugahara H, Lorenzo F, Watanabe Y, Kawakami K, Hosokai N, Yamamori S, Katayama N, Shiku H. Detection of the CBFB/MYH11 fusion gene in de novo acute myeloid leukemia (AML): A single-institution study of 224 Japanese AML patients. Leuk Res 2007; 31:471-6. [PMID: 17052753 DOI: 10.1016/j.leukres.2006.08.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2006] [Revised: 08/07/2006] [Accepted: 08/09/2006] [Indexed: 11/18/2022]
Abstract
The cytogenetic findings in acute myeloid leukemia (AML) are a powerful prognostic indicator. Among these abnormalities, the World Health Organization has classified inv(16)(p13q22), which is closely associated with the M4E classification in the French-American-British system, as indicating a good-risk AML. However, this chromosomal abnormality can often be difficult to detect. In this study, we used RT-PCR and FISH analysis to examine 224 Japanese adult de novo AML patients for the presence of the CBFB/MYH11 fusion transcript at the time of diagnosis. The CBFB/MYH11 fusion gene was detected in 17 patients (7.6%): eight patients had the inv(16) chromosome and in all of them it was M4E; nine patients did not have abnormalities in chromosome 16. AML with the CBFB/MYH11 fusion gene but without inv(16) was found in M2, M4, and M5, but not in M4E patients. There were no statistically significant differences in the clinical features of patients with the inv(16) and those with the cryptic inv(16) chromosome. These results indicate that even if eosinophilia is not found, molecular screening for CBFB/MYH11 fusion gene should be performed in all AML patients at the time of diagnosis to help guide disease management.
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Affiliation(s)
- Fumihiko Monma
- Division of Hematology and Oncology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan
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19
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Christopeit M, Mueller LP, Hainz M, Holzhausen HJ, Behre G. Cytogenetics detects infiltrations of a primary cutaneous acute myeloid leukemia to the kidney. Ann Hematol 2007; 86:291-3. [PMID: 17206419 DOI: 10.1007/s00277-006-0234-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2006] [Accepted: 11/21/2006] [Indexed: 11/24/2022]
Abstract
Extramedullary manifestations of acute myeloid leukemia (AML) are rare and commonly involve one tissue. We report of a cutaneous acute myelomonocytic leukemia infiltrating the kidney next to the skin. A 61-year-old female patient with complex karyotype cutaneous AML FAB M4 underwent abdominal computed tomography scans. A lesion in her left kidney appeared suspicious of renal carcinoma as confirmed by histology. However, fluorescence in situ hybridization cytogenetics revealed a chromosome 11q23 abnormality in the nephrectomy specimen, which also appeared in the leukemic blasts of skin and bone marrow. Closer histomorphologic workup revealed an infiltration of the kidney with leukemia. This case report illustrates how modern diagnostic procedures can help to reveal rare sites of disease.
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