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Haematological malignancy
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Clinically, all these forms of AML behave in a similar manner. Around half of all patients with AML will have chromosomal abnormalities. Recognized changes include trisomy of chromosome 8, deletions affecting chromosome 5 or 7, abnormalities of chromosome 11 and FLT3 mutations, all of which are poor prognostic features. A more complex classification based on molecular profiling by the WHO defines the following subgroups: AML with recurrent genetic abnormalitiesAML with myelodysplasia-related featuresTherapy-related myeloid neoplasmsAML, not otherwise specifiedMyeloid sarcomaMyeloid proliferations related to Down syndromeBlastic plasmacytoid dendritic cell neoplasm
The lymphoreticular system and bone marrow
Published in C. Simon Herrington, Muir's Textbook of Pathology, 2020
Clinically, all acute leukaemias are similar in that their effects are due to bone marrow failure. The proliferating malignant cells crowd out the normal haematopoietic elements, leading to anaemia, infections, and bleeding. The onset is often abrupt with fever, malaise, and sometimes bone pain. Rarely, acute leukaemia involves tissues other than the bone marrow such as the skin and gingiva. Occasionally, infiltrating myeloid leukaemia cells produce a tumour mass (myeloid sarcoma) in soft tissue or beneath the periosteum. This usually occurs when leukaemia is manifest, but it may precede the onset of overt disease by months.
Dermatological manifestations of malignancies and dermatological emergencies due to malignancy
Published in Biju Vasudevan, Rajesh Verma, Dermatological Emergencies, 2019
Extramedullary (EM) involvement of leukemias can occur in the presence or absence of bone marrow involvement. The spectrum of EM leukemia ranges from leukemia cutis (LC) to granulocytic sarcoma (GS), also known as chloroma, myeloid sarcoma, or myeloblastoma, which may overlap. LC can infiltrate the epidermis, dermis, and subcutis and present accordingly. LC is now used as an umbrella term for any cutaneous infiltration of leukemia. Further classification of lymphoid LC or myeloid LC is sometimes done depending on the cell type.
Myeloid sarcoma as a manifestation of acute myeloid leukemia
Published in Baylor University Medical Center Proceedings, 2021
Lewis Woods, Jerry Fan, Hameed Ali
The diagnosis of myeloid sarcoma is often a significant challenge, as it is asymptomatic until the patient experiences a mass effect from the tumor on surrounding structures.1,2 Our patient developed dyspnea due to bilateral pleural effusions because of the mass effect on the aorta, esophagus, and heart. Imaging including CT and magnetic resonance imaging are important diagnostic and prognostic tools for myeloid sarcoma.1,3 Core biopsy is often necessary for tissue diagnosis.1,3 In many cases of primary myeloid sarcoma (presence of a soft tissue mass in the absence of the diagnosis of AML), misdiagnosis is common—historically up to 75%, and with recent advancements in immunohistochemistry, flow cytometry, and fluorescence in situ hybridization, up to 25% to 47%.1
Myeloid sarcoma involving the greater wing of the sphenoid bone and additional skeletal sites presenting with unilateral proptosis and fevers
Published in Orbit, 2019
Jay C. Wang, Juan C. Jiménez Pérez, Alison M. Friedmann, Abner Louissaint, Suzanne K. Freitag
Myeloid sarcoma is a rare extramedullary tumor of leukemic blast cells that can be associated with acute myeloid leukemia (AML), myelodysplastic syndrome, or chronic myeloid leukemia. It may precede, occur concurrently with, or manifest with relapse of these systemic conditions, and may present at any age. In patients with AML, it has been reported in 2–8% of cases.1 The most common sites of involvement include skin, soft tissue, lymph nodes, periosteum, bone, and orbit. It is less commonly reported in the gastrointestinal tract and central nervous system. Furthermore, there have only been a few case reports of multifocal skeletal involvement.2–4 Herein, we report a case of myeloid sarcoma with multiple sites of extramedullary involvement, namely the left sphenoid wing, thoracic and lumbar vertebral bodies, pelvis, left humerus, and femora, which initially presented with unilateral proptosis and fevers. The collection and evaluation of protected patient health information was HIPAA-compliant. Written consent for permission to publish clinical photographs and the details of this case were obtained from the patient’s parents.
An unusual myeloid sarcoma
Published in Baylor University Medical Center Proceedings, 2022
John R. Krause, Samreen Fathima, Rory Richard Mayer, George J. Snipes
Myeloid sarcoma is an uncommon tumor mass of immature myeloid or monocytic cells or rarely erythroid or megakaryocytic precursors occurring in an extramedullary site.1 Myeloid sarcomas may occur de novo, may precede or coincide with acute myelocytic leukemia, or may represent a blast transformation of a preceding myelodysplastic disorder, myeloproliferative disorder, or myelodysplastic/myeloproliferative disorder. Almost any site in the body may be involved, but the most frequently involved areas are the skin, lymph nodes, gastrointestinal tract, soft tissue, and bone.2 We report a rare case of a granulocytic sarcoma presenting as a de novo acute promyelocytic leukemia.