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Chatterton S, Helou J, Drummond J, Gill AJ, Ward C, Coyle L, Kerridge I, Ng K. Unusual presentations of central nervous system myeloid sarcoma. Intern Med J 2022; 52:1083-1088. [PMID: 35718731 DOI: 10.1111/imj.15813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/09/2021] [Accepted: 11/09/2021] [Indexed: 11/27/2022]
Abstract
Myeloid sarcoma (MS), also termed 'chloroma' or 'granulocytic sarcoma', is a tumour mass consisting of myeloid blasts occurring at an anatomical site other than the bone marrow. MS occurs in up to 8% of patients with acute myeloid leukaemia. While MS typically involves the skin or lymph nodes, almost any tissue can be affected, and symptoms largely depend on the organ involved and subsequent mass effect. We present a case series of patients that presented to a tertiary hospital with MS affecting the central nervous system over a 4-month period. These three cases demonstrate the vast spectrum of clinical presentations of MS and, furthermore, show rare examples of intramedullary spinal cord involvement and disseminated intraparenchymal brain disease.
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Affiliation(s)
- Sophie Chatterton
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Jacob Helou
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - James Drummond
- Department of Radiology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Brain Imaging Laboratory, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Anthony J Gill
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Christopher Ward
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Luke Coyle
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Ian Kerridge
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.,NSW Health Pathology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Department of Haematology, Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Karl Ng
- Department of Neurology, Royal North Shore Hospital, Sydney, New South Wales, Australia.,Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
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Tousifullah M, Gupta AK, Meena JP, Seth R. B cell acute lymphoblastic leukaemia presenting with isolated soft tissue tumours: the non-myeloid sarcoma. BMJ Case Rep 2019; 12:12/10/e230982. [PMID: 31586956 DOI: 10.1136/bcr-2019-230982] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Soft tissue leukaemic masses are a well-described clinical feature of myeloid haematological neoplasms. In paediatric acute lymphoblastic leukaemia (ALL), such soft tissue leukaemic sarcomas have not been reported as a presenting feature. Here we report a 3-year-old boy with ALL who presented to us with isolated soft tissue swellings for a duration of 9 months. The significance of these 'non-myeloid' sarcomas in paediatric ALL is uncertain.
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Affiliation(s)
- Mohammad Tousifullah
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Aditya Kumar Gupta
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Jagdish Prasad Meena
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Seth
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
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Abstract
Myeloid sarcoma (MS) is a rare extramedullary tumor of malignant myeloid cells often associated with acute myeloid leukemia. We report a case of a 17-year-old boy presenting with diffuse red-brown skin nodules ultimately diagnosed with the scarcely described disseminated, de novo MS. It is important for dermatologists to keep MS on their differential when assessing patients with disseminated red-brown nodules.
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Affiliation(s)
- Matthew K Sandre
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
| | - Annie Liu
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
| | - Rebecca Levy
- Section of Dermatology, Division of Paediatric Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
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