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Salisbury T, Al-Mohammad A, Pirzada O. Isolated cardiac involvement of a primary myeloid sarcoma: a case report of an unusual cause of pulmonary oedema. Eur Heart J Case Rep 2023; 7:ytad088. [PMID: 36895307 PMCID: PMC9991049 DOI: 10.1093/ehjcr/ytad088] [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: 03/08/2022] [Revised: 06/14/2022] [Accepted: 02/16/2023] [Indexed: 02/20/2023]
Abstract
Background Myeloid sarcoma, also known as chloroma, is a pathologic diagnosis for an extramedullary proliferation of blasts of one or more of the myeloid lineages. It is an uncommon manifestation of acute myeloid leukaemia (AML), although the diagnosis may occur prior to or after diagnosis of AML. Cardiac infiltration by myeloid sarcoma is extremely rare, and of the few published cases, a diagnosis of leukaemia was almost always already present. Case summary This is a 52-year-old patient admitted to the hospital with acute shortness of breath, with a large amorphous mass found on computed tomography scan invading the myocardium and causing heart failure. Echocardiography demonstrated multiple cardiac masses. A bone marrow biopsy was non-diagnostic. An endomyocardial biopsy confirmed a cardiac primary myeloid sarcoma. The patient was successfully treated with chemotherapy with complete resolution of the cardiac infiltration and of the heart failure. Discussion We present this rare case of primary cardiac myeloid sarcoma and discuss current literature relevant to this effectively unique presentation. We discuss the use of endomyocardial biopsy in the diagnosis of cardiac malignancy and the advantages of early diagnosis and management of this unusual cause of heart failure.
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Affiliation(s)
- Thomas Salisbury
- Internal Medical Trainee, Sheffield Teaching Hospitals, Herries Road, S5 7AU Sheffield, UK
| | - Abdallah Al-Mohammad
- Consultant in Cardiology, Sheffield Teaching Hospitals, Herries Road, S5 7AU Sheffield, UK
| | - Omar Pirzada
- Consultant in Respiratory Medicine, Sheffield Teaching Hospitals, Herries Road, S5 7AU Sheffield, UK
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Wilson HC, Hashemi S, Sabnis HS, Hong AL, Michelfelder EC. Inflammation or Infiltration? Infiltrative Cardiovascular Chloroma Presenting With Syncope and Heart Block. Circ Cardiovasc Imaging 2023; 16:e014532. [PMID: 36649458 DOI: 10.1161/circimaging.122.014532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Hunter C Wilson
- Emory University School of Medicine, Children's Heart Center, Children's Healthcare of Atlanta, GA (H.C.W., E.C.M.)
| | | | - Himalee S Sabnis
- Emory University School of Medicine, Aflac Center for Cancer and Blood Disorders, Children's Healthcare of Atlanta, GA (H.S.S., A.L.H.)
| | - Andrew L Hong
- Emory University School of Medicine, Aflac Center for Cancer and Blood Disorders, Children's Healthcare of Atlanta, GA (H.S.S., A.L.H.)
| | - Erik C Michelfelder
- Emory University School of Medicine, Children's Heart Center, Children's Healthcare of Atlanta, GA (H.C.W., E.C.M.)
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Jayaraman D, Bhurat R, Rathinasamy J, Shanmugam SG, Scott JX, Sivaraman RP, Sneha LM. A Journey Across Oceans With a Heavy Heart: Rare Presentation of a Pediatric Malignancy. JACC Case Rep 2021; 3:1221-1226. [PMID: 34401764 PMCID: PMC8353567 DOI: 10.1016/j.jaccas.2021.03.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 03/01/2021] [Accepted: 03/25/2021] [Indexed: 11/24/2022]
Abstract
Myeloid sarcoma, due to extramedullary deposition of myeloblasts, is one of the rare presentations in acute myeloid leukemia. We present an extremely rare case of a 5-year-old boy with cardiac myeloid sarcoma. Noninvasive mode of diagnosis, timely initiation of chemotherapy and meticulous supportive care are the keys to successful outcome. (Level of Difficulty: Intermediate.)
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Affiliation(s)
- Dhaarani Jayaraman
- Division of Pediatric Hemato-Oncology, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Rishab Bhurat
- Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Jebaraj Rathinasamy
- Division of Paediatric Cardiology, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Sri Gayathri Shanmugam
- Department of Pathology, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Julius Xavier Scott
- Division of Pediatric Hemato-Oncology, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Rajakumar Padur Sivaraman
- Division of Pediatric Intensive Care, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Latha M Sneha
- Division of Pediatric Hemato-Oncology, Department of Pediatrics, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
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Sahu KK, Mishra K, Malhotra P. Extramedullary Deposits in Leukemia: Out of Blood but Not Out of Mind. J Microsc Ultrastruct 2020; 8:35-36. [PMID: 32166064 PMCID: PMC7045624 DOI: 10.4103/jmau.jmau_61_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, 01608, MA, USA
| | - Kundan Mishra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Pankaj Malhotra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Sahu KK, Mishra K, Malhotra P. Extramedullary Deposits in Leukemia: Out of Blood but Not Out of Mind. J Microsc Ultrastruct 2020. [PMID: 32166064 DOI: 10.4103/jmau.jmau_61_18.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kamal Kant Sahu
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, Worcester, 01608, MA, USA
| | - Kundan Mishra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Pankaj Malhotra
- Clinical Hematology Division, Department of Internal Medicine, Post-Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Sahu KK, Doshi A, Mishra AK, Kranis M. A female with five chambers. Neth Heart J 2019; 28:174-175. [PMID: 31654327 PMCID: PMC7052089 DOI: 10.1007/s12471-019-01339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- K K Sahu
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, 01608, Worcester, MA, United States.
| | - A Doshi
- Department of Cardiovascular diseases, Saint Vincent Hospital, 123 Summer Street, 01608, Worcester, MA, United States
| | - A K Mishra
- Department of Internal Medicine, Saint Vincent Hospital, 123 Summer Street, 01608, Worcester, MA, United States
| | - M Kranis
- Department of Cardiovascular diseases, Saint Vincent Hospital, 123 Summer Street, 01608, Worcester, MA, United States
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Evers D, Bär BMAM, Gotthardt M, van der Velden WJFM. Activity of decitabine in pericardial myeloid sarcoma. Int J Hematol 2018; 108:121-122. [PMID: 29779081 DOI: 10.1007/s12185-018-2470-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 05/02/2018] [Accepted: 05/10/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Dorothea Evers
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands
| | - Brigitte M A M Bär
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands
| | - Martin Gotthardt
- Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Walter J F M van der Velden
- Department of Hematology, Radboud University Medical Center, Geert Grooteplein 8, 6500 HB, Nijmegen, The Netherlands.
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