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Journal of Clinical and Experimental... 2023Myeloid sarcoma (MS) is a condition characterized by a tumor mass of myeloid blasts in any site of the body other than the bone marrow, with or without acute myeloid...
Myeloid sarcoma (MS) is a condition characterized by a tumor mass of myeloid blasts in any site of the body other than the bone marrow, with or without acute myeloid leukemia. A 93-year-old man underwent laparoscopy-assisted distal gastrectomy with D1 lymphadenectomy for advanced gastric cancer. Other than metastatic foci of gastric cancer cells, some dissected lymph nodes showed destructive architecture with proliferation of small- to medium-sized atypical hematopoietic cells. Those cells were focally positive for naphthol AS-D chloroacetate esterase. Immunohistochemically, positive results were obtained for CD4, CD33, CD68 (KP1), Iba-1, lysozyme, myeloperoxidase, and PU.1, with focally positive results for CD13, CD14, CD68 (PGM1), CD163, and CD204, and negative results for AE1/AE3, CD1a, CD3, CD20, and S-100 protein. These results suggested MS with phenotypically myelomonocytic differentiation. We report a rare case of MS incidentally found in specimens resected for other purposes. Careful diagnosis and consideration of differential diagnoses including MS using an adequate panel of antibody markers for dissected lymph nodes is warranted.
Topics: Humans; Male; Aged, 80 and over; Stomach Neoplasms; Sarcoma, Myeloid; Lymph Nodes; Adenocarcinoma; Biomarkers, Tumor; Treatment Outcome
PubMed: 37380469
DOI: 10.3960/jslrt.23013 -
Indian Journal of Pathology &... 2022Myeloid sarcoma (MS) is an extramedullary proliferation of immature myeloid cells which may occur as a progression of myelodysplastic syndrome (MDS), myeloproliferative...
Myeloid sarcoma (MS) is an extramedullary proliferation of immature myeloid cells which may occur as a progression of myelodysplastic syndrome (MDS), myeloproliferative neoplasm (MPN), or myelodysplastic syndrome/myeloproliferative neoplasm (MDS/MPN) and as acute myeloid leukemia (AML) relapse. Rarely may it be de novo. Lymph nodes, skin, lungs, intestine are the commonly involved sites. However, an isolated pancreatic MS is seldom reported in the literature. Herein, we report one such case which was misdiagnosed as pancreatic adenocarcinoma on the clinico-radiological examination which misled us away from preoperative diagnostic sampling, and a Whipple pancreaticoduodenectomy was performed. Histopathological examination in conjunction with immunohistochemistry revealed the final diagnosis of isolated MS of the pancreas. We emphasize that although rare, a clinical suspicion along with preoperative histopathological examination may lead to early diagnosis, targeted management, and a better clinical outcome in such cases.
Topics: Adenocarcinoma; Humans; Leukemia, Myeloid, Acute; Myelodysplastic Syndromes; Pancreas; Pancreatic Neoplasms; Sarcoma, Myeloid
PubMed: 35900500
DOI: 10.4103/ijpm.ijpm_202_21 -
Internal Medicine Journal Jun 2022Myeloid 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...
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.
Topics: Central Nervous System Neoplasms; Humans; Sarcoma, Myeloid
PubMed: 35718731
DOI: 10.1111/imj.15813 -
Applied Immunohistochemistry &... Apr 2022To describe the clinical, histologic, immunophenotypic, and genetic characteristics of myeloid sarcoma (MS) diagnosed in the testes of adults, 3 cases were identified,...
To describe the clinical, histologic, immunophenotypic, and genetic characteristics of myeloid sarcoma (MS) diagnosed in the testes of adults, 3 cases were identified, and information on their presentation, clinical features, treatment, and outcome was retrieved from the medical records. In addition, histologic, immunophenotypic, and molecular characteristics were reviewed. This showed that all patients had a previous history of acute myeloid leukemia (AML), in 2 cases diagnosed >10 years before the testicular lesions. In 1 case, there was bilateral involvement, while in 2, involvement was unilateral. The neoplastic cells showed evidence of cytogenetic/molecular clonal evolution in all cases, 1 of which also had significant immunophenotypic changes. A mutational profile including NPM1 p.Trp288Cysfs*12, IDH1 p.Arg132His NRAS p.Gly12Asp was seen in 2 of the 3 cases. Concurrent bone marrow involvement by a myeloid neoplasm was diagnosed in 2 patients, in 1, there was AML in the second 8% blasts. These patients progressed rapidly after MS and had a dismal outcome. The patient with no concurrent bone marrow disease had a favorable outcome. In conclusion, MS involving the testes of adults is a rare event, and it may represent the clonal evolution of AML.
Topics: Adult; Clonal Evolution; Humans; Leukemia, Myeloid, Acute; Male; Mutation; Nuclear Proteins; Nucleophosmin; Sarcoma, Myeloid; Testis
PubMed: 35001036
DOI: 10.1097/PAI.0000000000001007 -
The Indian Journal of Medical Research Nov 2020
Topics: Humans; Sarcoma, Myeloid
PubMed: 35345209
DOI: 10.4103/ijmr.IJMR_2328_19 -
Acta Haematologica 2022Myeloid sarcoma (MS) is a very rare disease in both adults and children. Prognosis is poor in adults; in the pediatric age, the prognostic impact of extramedullary...
Myeloid sarcoma (MS) is a very rare disease in both adults and children. Prognosis is poor in adults; in the pediatric age, the prognostic impact of extramedullary disease is controversial. Systemic therapy represents the mainstay of treatment even in isolated MS, but a comparison between different induction regimens is very limited in the literature. To date, it is still not clear if induction treatment should differ from that of other acute myeloid leukemias and stem cell transplant is considered for consolidation in both leukemic patients and in those with isolated disease. Our study describes a retrospective series of 13 cases of MS (adults and children), diagnosed and treated at our institute over 18 years. We report the results of immunophenotypic, cytogenetic and molecular studies, therapeutic approaches, and outcome, in order to establish the best strategy for patients' workup.
Topics: Adolescent; Adult; Allografts; Child; Child, Preschool; Hematopoietic Stem Cell Transplantation; Humans; Male; Middle Aged; Retrospective Studies; Sarcoma, Myeloid
PubMed: 34284384
DOI: 10.1159/000517389 -
The American Journal of the Medical... Aug 2007Myeloid sarcoma (MS) is a very rare disease that either presents with acute myeloid leukemia or as relapse of acute myeloid leukemia. The common sites include the small... (Review)
Review
Myeloid sarcoma (MS) is a very rare disease that either presents with acute myeloid leukemia or as relapse of acute myeloid leukemia. The common sites include the small intestine, skin, bone, and lymph nodes. We present an unusual case of MS presenting with acute renal failure (ARF) and bilateral ureteral obstruction. Ultrasonography showed bilateral hydronephrosis and a large pelvic mass displacing the uterus. Pelvic mass biopsy showed fibroadipose tissue with diffuse neoplastic cell infiltration and immunostaining was positive for leukocyte common antigen (LCA) and myeloperoxidase consistent with myeloid sarcoma. Bone marrow biopsy revealed 63% myeloblasts. The patient died the 17th day of induction therapy. We came across only four MS cases in English literature that presented with ARF. To our knowledge, this case is the first description of myeloid sarcoma presenting with ARF and bilateral ureteral obstruction not originating from urogenital system. Physicians should consider possible hematological malignancies in patients with similar presentation.
Topics: Acute Kidney Injury; Female; Humans; Middle Aged; Sarcoma, Myeloid; Ureteral Obstruction
PubMed: 17700206
DOI: 10.1097/MAJ.0b013e31812e978b -
BMJ Case Reports Dec 2022A female patient in her 70s with a medical history of myelodysplastic neoplasm presented to the outpatient department with a 4-month history of toothache, painful...
A female patient in her 70s with a medical history of myelodysplastic neoplasm presented to the outpatient department with a 4-month history of toothache, painful gingival swelling and loose teeth that required extractions. Intraoral examination revealed a swelling in the lower anterior portion of the mandible, which displaced her teeth. Incisional biopsy of the gingival lesion revealed dense aggregates of atypical round cells which stained positive for CD43, CD45, CD33 and myeloperoxidase, consistent with myeloid sarcoma. Subsequent bone marrow biopsy displayed hypercellular marrow with immature myeloid elements and 21% myeloblasts by flow cytometry, compatible with diagnosis of acute myeloid leukaemia (AML). The patient initially went into remission after treatment but later died of AML relapse after 18 months.
Topics: Humans; Female; Sarcoma, Myeloid; Toothache; Neoplasm Recurrence, Local; Leukemia, Myeloid, Acute; Bone Marrow
PubMed: 36593620
DOI: 10.1136/bcr-2022-251452 -
AJR. American Journal of Roentgenology May 2012Myeloid sarcoma (MS) is a rare extramedullary manifestation of acute myeloid leukemia that often presents during remission or disease relapse. With awareness of this... (Review)
Review
OBJECTIVE
Myeloid sarcoma (MS) is a rare extramedullary manifestation of acute myeloid leukemia that often presents during remission or disease relapse. With awareness of this clinical entity and the appropriate clinical history, MS can be detected despite its nonspecific radiologic features.
CONCLUSION
This article highlights the utility of (18)F-FDG PET/CT, which has high sensitivity in detecting early MS and provides a systemic overview of tumor burden, and its potential role in monitoring of treatment response.
Topics: Female; Fluorodeoxyglucose F18; Humans; Male; Multimodal Imaging; Neoplasm Staging; Positron-Emission Tomography; Radiopharmaceuticals; Sarcoma, Myeloid; Sensitivity and Specificity; Tomography, X-Ray Computed
PubMed: 22528910
DOI: 10.2214/AJR.11.7743 -
Leukemia & Lymphoma May 2023Myeloid sarcoma (MS) is currently considered equivalent to de novo acute myeloid leukemia (AML); however, the relationship between these entities is poorly understood....
Myeloid sarcoma (MS) is currently considered equivalent to de novo acute myeloid leukemia (AML); however, the relationship between these entities is poorly understood. This retrospective multi-institutional cohort study compared 43 MS with mutation to 106 AML with mutation. Compared to AML, MS had more frequent cytogenetic abnormalities including complex karyotype ( = .009 and = .007, respectively) and was enriched in mutations of genes involved in histone modification, including ( = .007 and = .008, respectively). AML harbored a higher average number of gene mutations ( = .002) including more frequent mutations ( < .001) and mutations of DNA-methylating genes including and (both < .001). MS had significantly shorter overall survival (OS) than AML (median OS: 44.9 vs. 93.2 months, respectively, = .037). MS with mutation has a unique genetic landscape, and poorer OS, compared to AML with mutation.
Topics: Humans; Bone Marrow; Nuclear Proteins; Nucleophosmin; Sarcoma, Myeloid; Retrospective Studies; Cohort Studies; Leukemia, Myeloid, Acute; Mutation; Prognosis
PubMed: 36960680
DOI: 10.1080/10428194.2023.2185091