A practical approach to diagnose soft tissue myeloid sarcoma preceding or coinciding with acute myeloid leukemia

Seifert, Robert; Bulkeley, William; Zhang, Ling; Menes, Manuel

doi:10.1016/j.anndiagpath.2014.06.001

Cited by 37 publications

(29 citation statements)

References 13 publications

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“…Immunohistochemistry can help diagnose different variants of MS including cases showing granulocytic (eg, myeloperoxidase and CD117 positivity), monoblastic (eg, CD68, CD43, CD33, CD163, CD56, CD14, and lysozyme positivity), myelomonoblastic (mixed pattern of immunoreactivity), erythroid (eg, glycophorin A, hemoglobin, or CD71 positivity), or megakaryoblastic (eg, factor VIII, CD31, CD41, and CD61 positivity) differentiation. 12,23,24 Flow cytometry was particularly helpful in cases without high blast cellularity. In addition, the It is particularly helpful to detect any previously known cytogenetic or molecular abnormalities when dealing with scant material.…”

Section: Discussionmentioning

confidence: 99%

Cytopathology of myeloid sarcoma: a study of 16 cases

Singhal

Pantanowitz

2015

Journal of the American Society of Cytopathology

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Section: Discussionmentioning

confidence: 99%

Cytopathology of myeloid sarcoma: a study of 16 cases

Singhal

Pantanowitz

2015

Journal of the American Society of Cytopathology

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“…With the advent of immunohistochemistry, most cases can be diagnosed correctly by applying proper immunohistochemical stains. A number of immunohistochemical markers have been shown to have diagnostic utility in extramedullary leukemia, 267,281,292,293 including immature hematopoietic markers, such as CD34, CD117, and TdT; lineage markers, such as CD3, PAX5, CD19, CD79a, MPO, and CD61; monocytic markers; and markers for blastic plasmacytoid dendritic cell neoplasms. The second concern raised was that the biopsy tissue sample may be small, especially in patients with cutaneous involvement, and there may not be sufficient tissue for a complete AL workup.…”

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confidence: 99%

“…Extramedullary AL (myeloid sarcoma) has been shown to present months, or even years, before AML becomes evident in the BM or PB in some patients. [267][268][269][270][271] Myeloid sarcoma also can occur in patients with MDS, myeloproliferative neoplasms, or myelodysplastic/myeloproliferative neoplasms whose BM or PB may never meet the diagnostic criteria for AML. The incidence of extramedullary leukemic involvement varies widely among reports in the literature.…”

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confidence: 99%

“…280 Fresh specimens, either fine-needle aspirate, excisional biopsy, or body-effusion fluids, are adequate for leukemia workup. 267,[281][282][283][284][285][286] Similar to the analysis for BM and PB samples, the workup includes morphologic examination, FCI, and cytogenetic and molecular studies. In patients with suspected CNS leukemia, 287 a CSF sample may be obtained.…”

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confidence: 99%

“…Paraffinembedded tissue is adequate for immunohistochemical analysis, FISH, and some molecular testing. 267,[281][282][283][284]286 When a diagnosis of extramedullary leukemia is confirmed or highly suspected based on the initial biopsy, additional biopsies may be indicated to obtain fresh material for ancillary testing.…”

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confidence: 99%

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Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

Arber¹,

Borowitz²,

Cessna³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

100

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Context.-A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia.Objective.-To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage.Design.-The College of American Pathologists and the American Society of Hematology convened a panel of experts in hematology and hematopathology to develop recommendations. A systematic evidence review was conducted to address 6 key questions. Recommendations were derived from strength of evidence, feedback received during the public comment period, and expert panel consensus.Results.-Twenty-seven guideline statements were established, which ranged from recommendations on what clinical and laboratory information should be available as part of the diagnostic and prognostic evaluation of acute leukemia samples to what types of testing should be performed routinely, with recommendations on where such testing should be performed and how the results should be reported.Conclusions.-The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant.

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