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Nuclear Medicine and Molecular Imaging Jun 2012Tetrasomy 8 is a relatively rare chromosomal abnormality that has been reported in only 33 cases in hematologic disorders. It is known for its association with...
Tetrasomy 8 is a relatively rare chromosomal abnormality that has been reported in only 33 cases in hematologic disorders. It is known for its association with aggressive acute myeloid leukemia (AML) and myeloid sarcoma and is considered a very poor prognostic factor. Myeloid sarcoma is a rare hematologic malignancy characterized by tumor masses consisting of immature myeloid cells, presenting at an extramedullary site. We present a case of a 17-year-old boy referred for an (18)F-FDG PET/CT for the evaluation of pleural masses and spinal bone lesions seen on CT, after presenting with a 4 month history of chest pain. The PET/CT revealed extensive FDG-avid extramedullary disease in the soft tissues of the chest, abdomen, and pelvis, which were biopsy-proven to be myeloid sarcoma, as well as extensive intramedullary disease biopsy proven to be AML. This is the first report of the use of (18)F-FDG PET/CT to stage a subset of aggressive AML and myeloid sarcoma in a patient with an associated chromosomal abnormality (tetrasomy 8).
PubMed: 24900045
DOI: 10.1007/s13139-012-0128-x -
Turkish Journal of Haematology :... May 2019
Topics: Child; Disease-Free Survival; Female; Humans; Male; Orbital Neoplasms; Sarcoma, Myeloid; Survival Rate
PubMed: 30650963
DOI: 10.4274/tjh.galenos.2019.2019.0002 -
Annals of Hematology Feb 2021Isolated myeloid sarcoma (MS) is a rare malignancy in which myeloid blast forms tumors at various locations while the bone marrow (BM) remains cytomorphologically free...
Isolated myeloid sarcoma (MS) is a rare malignancy in which myeloid blast forms tumors at various locations while the bone marrow (BM) remains cytomorphologically free from disease. We analyzed isolated MS from four patients and their BMs at initial diagnosis and follow-up, using a custom next-generation sequencing (NGS) panel. We observed possible clonal evolution and a clonal hematopoiesis of indeterminate potential (CHIP)-like finding in the BM of one of three cases with detectable mutations. Clinical presentation of one patient suggested extramedullary confined homing of blasts to distal sites in the relapse situation still sparing the BM. In summary, our findings shall motivate future work regarding signals of extramedullary blast trafficking and clonal evolution in MS.
Topics: Adult; Aged; Bone Marrow; Bone Marrow Neoplasms; Clonal Evolution; High-Throughput Nucleotide Sequencing; Humans; Male; Sarcoma, Myeloid
PubMed: 33108522
DOI: 10.1007/s00277-020-04313-x -
Archives of Pathology & Laboratory... Oct 2006Granulocytic sarcoma is an extramedullary tumor of myeloblasts and/or immature myeloid cells, which can develop at any anatomic site and is often a forerunner to the... (Review)
Review
Granulocytic sarcoma is an extramedullary tumor of myeloblasts and/or immature myeloid cells, which can develop at any anatomic site and is often a forerunner to the development of acute myelogenous leukemia. Granulocytic sarcoma of the gastrointestinal tract most frequently involves the small intestine and most often presents with abdominal pain and obstruction. Pathologists must consider granulocytic sarcoma in any mass of unknown origin with a diffusely infiltrating population of tumor cells, as the diagnosis is often initially unrecognized, especially in nonleukemic patients. Multiple ancillary modalities are available to assist pathologists in making the correct diagnosis so that appropriate therapy can be initiated.
Topics: Abdominal Pain; Diagnosis, Differential; Humans; Intestinal Neoplasms; Intestinal Obstruction; Intestine, Small; Prognosis; Sarcoma, Myeloid
PubMed: 17090205
DOI: 10.5858/2006-130-1570-GSOTSI -
International Journal of Cancer Aug 2013Extramedullary manifestations of acute myeloid leukemia (AML) were described as early as the 19th century. However, the incidence, clinical significance and pathobiology... (Review)
Review
Extramedullary manifestations of acute myeloid leukemia (AML) were described as early as the 19th century. However, the incidence, clinical significance and pathobiology of extramedullary AML remain ill defined. We reviewed case reports, retrospective case series, pilot studies and imaging studies of extramedullary leukemia (EML) to determine its frequency, characteristics, clinical presentation and significance. EML precedes or accompanies development of AML and occurs during or following treatment, even during remission. Although imaging studies are rarely conducted and the true incidence of EML has yet to be verified, authors have reported several estimates based on retrospective and autopsy studies. The incidence of EML in patients with AML of all ages is estimated to be about 9% and EML in children with AML was detected in 40% of patients at diagnosis. The combination of positron emission tomography and computed tomography were the most sensitive and reliable techniques of detecting and monitoring EML. Based on our literature review, the frequency of EML is likely underreported. The well-documented nature of EML in patients with AML suggests that AML can manifest as a solid tumor. The extent to which EML accompanies AML and whether EML is derived from bone marrow are unknown. Furthermore, questions remain regarding the role of the microenvironment, which may or may not facilitate the survival and proliferation of EML, and the implications of these interactions with regard to minimal residual disease, tumor cell quiescence and relapse. Therefore, prospective studies of detection and characterization of EML in patients with AML are warranted.
Topics: Cell Proliferation; Cell Survival; Humans; Leukemia, Myeloid, Acute; Myeloproliferative Disorders; Prognosis; Recurrence; Sarcoma, Myeloid; Treatment Outcome; Tumor Microenvironment
PubMed: 23280377
DOI: 10.1002/ijc.28012 -
Leukemia Research Reports 2021Myelodysplastic syndrome (MDS) are hematologic neoplasms characterized by morphologic dysplasia and ineffective hematopoiesis in the bone marrow. The only potentially...
INTRODUCTION
Myelodysplastic syndrome (MDS) are hematologic neoplasms characterized by morphologic dysplasia and ineffective hematopoiesis in the bone marrow. The only potentially curative therapy is stem cell transplant. However, relapse remains a major challenge and is seen in about 25-40% of cases. Myeloid sarcoma presenting as relapse post allogeneic transplant for myeloid neoplasms is rare. We report the sentinel case of a patient with MDS who relapsed as gastric myeloid sarcoma 1 ½ years after allogeneic stem cell transplant.
CASE PRESENTATION
Sixty-nine-year-old male who was diagnosed with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) in 2006 and transitional cell bladder carcinoma in 2008. In 2011, he developed therapy-related myeloid neoplasm t(7;22) and no excess blasts. He was treated with Vidaza followed by a MUD hematopoietic stem cell transplant on 8/24/2012. In 2013 the patient developed anorexia and gastric biopsies showed severe gastritis. Repeat gastric biopsy on 02/05/2014 showed an extensive mononuclear infiltrate which could easily be confused with lymphocytes but staining showed myeloid sarcoma. Marrow was negative. The patient remained refractory to therapy and expired 08/10/2016.
CONCLUSION
In summary, we report the first case of GI relapse of MDS as a myeloid sarcoma post-transplant. We seek to alert our audience of this potentially serious diagnostic pitfall, particularly one that can be relatively easily resolved on the basis of immunohistochemical profiling.
PubMed: 34113541
DOI: 10.1016/j.lrr.2021.100244 -
Medicine Oct 2017Myeloid sarcomas (MSs) are rare malignant hematological tumors. They most commonly occur in patients with acute or chronic myeloid leukemia. A de novo MS with no... (Review)
Review
RATIONALE
Myeloid sarcomas (MSs) are rare malignant hematological tumors. They most commonly occur in patients with acute or chronic myeloid leukemia. A de novo MS with no evidence of blood system disease is rare, but may represent the first sign of a systemic illness that precedes a full-blown disease. Herein, we report the computed tomography (CT) findings of an extremely rare case of a nonleukemic MS that progressed to acute myelogenous leukemia (AML) and simultaneously involved the small intestine, kidneys, mesentery, and mesenteric lymph nodes. Moreover, we provide CT findings before and after AML chemotherapy, which have not been reported previously.
PATIENT CONCERNS
A 25-year-old man with intermittent upper abdominal pain for 6 months was admitted to the hospital on November 28, 2015. Initial CT showed concentric wall thickening of the jejunum with an adjacent mesenteric soft tissue mass and mesenteric lymph nodes enlargement. Both kidneys were involved as indicated by the presence of well-defined mildly dilated lesions. During the laparoscopic surgery, the small intestinal tumor, mesenteric soft tissue mass, and mesenteric lymph nodes were removed.
DIAGNOSES
The pathological diagnosis was an MS.
INTERVENTIONS
The patient refused systemic chemotherapy and was rehospitalized with persistently aggravated abdominal distension on February 17, 2016. Follow-up CT showed diffuse small bowel wall thickening, widespread infiltration of the peritoneum, omentum, and mesentery, mesenteric lymph node enlargement, and large amounts of ascites fluid. The lesions in both kidneys were substantially larger and more numerous than on initial CT. Then the patient was treated with conventional AML chemotherapy.
OUTCOMES
The patient achieved complete hematological remission on bone marrow examination. Follow-up CT in September 4, 2016, showed none of the abnormalities seen on initial CT. Currently, the patient is in complete remission.
LESSONS
If the radiological examination shows lesions at multiple sites, and these lesions are soft tissue masses with homogenous enhancement, MS should be considered in the differential diagnosis, and an aspiration biopsy should be performed to provide a definitive pathological diagnosis. If MS is diagnosed, systemic chemotherapy is crucial to recovery; otherwise, the disease may progress rapidly. Medical imaging is helpful for diagnosing MS and for monitoring treatment response.
Topics: Abdominal Pain; Adult; Diagnosis, Differential; Humans; Intestinal Neoplasms; Intestine, Small; Kidney; Kidney Neoplasms; Lymph Nodes; Male; Mesentery; Neoplasms, Multiple Primary; Peritoneal Neoplasms; Sarcoma, Myeloid; Tomography, X-Ray Computed
PubMed: 29049187
DOI: 10.1097/MD.0000000000007934 -
The British Journal of Radiology 2016The periportal space is a potential space surrounding the portal vein and its intrahepatic branches. A variety of neoplasms can involve the periportal region, whether... (Review)
Review
The periportal space is a potential space surrounding the portal vein and its intrahepatic branches. A variety of neoplasms can involve the periportal region, whether primary or secondary, owing to contiguous spread from surrounding hepatic parenchyma or from adjacent organs. CT plays an important role in not only diagnosing these lesions but also determining the extent of the disease. Most of the malignancies leading to the periportal spread manifest as periportal hypodensity either distinctly or in contiguity with the primary tumour. Even in known malignancies, periportal hypodensity commonly results from non-neoplastic causes like periportal oedema; hence, a knowledge of the imaging findings to ascertain its presence as well as to conclude the definite neoplastic spread is prudent. Periportal spread of neoplasm may suggest locally aggressive or disseminated disease (in extrahepatic malignancies), which may change management accordingly.
Topics: Carcinoma, Hepatocellular; Cholangiocarcinoma; Gallbladder Neoplasms; Hepatoblastoma; Histiocytosis, Langerhans-Cell; Humans; Liver Neoplasms; Lymphoma; Neoplasm Metastasis; Neoplasms, Vascular Tissue; Neurofibroma; Peritoneal Neoplasms; Portal Vein; Sarcoma, Myeloid; Tomography, X-Ray Computed
PubMed: 26800313
DOI: 10.1259/bjr.20150756 -
Turkish Neurosurgery 2014Myeloid sarcoma initially occurring in the sacral canal is often misdiagnosed as other pathological tumors on MRI due to the lack of a definite history or clinical... (Review)
Review
Myeloid sarcoma initially occurring in the sacral canal is often misdiagnosed as other pathological tumors on MRI due to the lack of a definite history or clinical evidence of granulocytic leukemia. Here, we report a case of 24-year-old male patient with myeloid sarcoma misdiagnosed radiologically. On MRI, sacral myeloid sarcoma is characterized by homogeneous signal intensity, marked enhancement, and the lack of cystic degeneration, calcification and necrosis. Based on our study of this patient and review of the relevant literature, we believe that these MRI features in the sacral region may help us differentiate it from other pathological tumors, which could prompt further clinical examinations to confirm the diagnosis of granulocytic leukemia.
Topics: Diagnosis, Differential; Diagnostic Errors; Humans; Leukemia, Myeloid; Magnetic Resonance Imaging; Male; Sarcoma, Myeloid; Tomography, X-Ray Computed; Young Adult
PubMed: 24831376
DOI: 10.5137/1019-5149.JTN.7125-12.1 -
BioMed Research International 2019Myeloid sarcoma (MS) is a rarely encountered extramedullary localized tumor that is composed of immature myeloid cells. We reported an extremely rare case of MS with... (Review)
Review
Myeloid sarcoma (MS) is a rarely encountered extramedullary localized tumor that is composed of immature myeloid cells. We reported an extremely rare case of MS with concurrent bone marrow (BM) involvement that invaded into a preexisting sebaceous lymphadenoma in the parotid gland and neck lymph nodes. Prompted by this case, we also present a literature review of MS invasion into salivary glands. A 62-year-old man was initially diagnosed with carcinoma that arose in a sebaceous lymphadenoma in the parotid gland, through a total parotidectomy with neck dissection. After an extensive histopathological review that included immunohistochemistry, a pathologic diagnosis of MS with infiltration into the sebaceous lymphadenoma with concurrent BM involvement was confirmed. MS is difficult to diagnose accurately; herein, we analyzed the clinical presentations and effectiveness of the various diagnostic methods with a review of the literature. There are 17 cases, including our case, reported in 13 studies. Of the cases in which the salivary glands were affected, 10 involved the parotid gland, six involved the submandibular gland, and one involved both. Isolated invasion of the salivary gland was found in one case of parotid gland invasion and three cases of submandibular gland invasion. In 13 cases, the salivary glands were affected by various other lesions. Although there were no incidences of isolated MS, six patients were diagnosed with secondary MS and eight patients with MS with BM involvement, including this case. The diagnosis of MS is difficult given its rarity, and a high index of suspicion and integrated radiologic and careful histopathologic evaluation are required. Most cases of MS infiltrating the salivary gland might be indicated by the possibility of BM involvement. MS with BM involvement predicts poor prognosis and the need for intensive systemic treatment.
Topics: Adenolymphoma; Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Parotid Gland; Parotid Neoplasms; Sarcoma, Myeloid; Sebaceous Gland Neoplasms; Sebaceous Glands; Young Adult
PubMed: 31886274
DOI: 10.1155/2019/9869406