Diffuse osteolytic lesions in leukemic transformation of myelofibrosis

Jurišić, Vladimir; Čolović, Nataša; Pavlović, Sonja; Čolović, Milica

doi:10.2298/aoo0702045j

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…It is also very rare for osteolytic lesions to occur with AML. Osteolytic lesions have been described with leukemic transformation in myelofibrosis [ 10 ] but, to our knowledge, there has not been a reported case of AML that has presented with both osteolytic lesions and BMN.…”

Section: Discussionmentioning

confidence: 99%

Extensive Bone Marrow Necrosis and Osteolytic Lesions in a Case of Acute Myeloid Leukemia Transformed from Polycythemia Vera

Chambers¹,

Truong²,

Kj³

et al. 2016

Cureus

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Acute myeloid leukemia (AML) is the most common leukemia in adults. In rare cases, bone marrow necrosis (BMN) and osteolytic lesions are presenting features of AML. The following case describes a patient with known polycythemia vera (PV) that presented with signs of multiple myeloma, including hypercalcemia, anemia, and lytic lesions of the thoracic spine and skull. Laboratory workup was not indicative of myeloma. A bone marrow biopsy was performed, which revealed extensive BMN and initial pathology was consistent with metastatic carcinoma. However, no immunohistochemical stains could be performed due to the extent of BMN; a repeat biopsy was therefore performed. Flow cytometry and CD45 staining were consistent with PV that had transformed to AML. Due to the patient’s comorbidities, she was a poor candidate for stem cell transplant and did not wish to pursue chemotherapy. Ultimately, she pursued hospice care. Based on our literature review, both BMN and osteolytic lesions are rare manifestations of AML and have not been reported to occur simultaneously. These findings can lead to a diagnostic dilemma and suspicion of other malignancies. This case demonstrates that AML should remain in the differential diagnosis in those patients who present with BMN and osteolytic lesions.

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Section: Discussionmentioning

confidence: 99%

Extensive Bone Marrow Necrosis and Osteolytic Lesions in a Case of Acute Myeloid Leukemia Transformed from Polycythemia Vera

Chambers¹,

Truong²,

Kj³

et al. 2016

Cureus

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“…HAL are usually secondary in nature and have been reported to develop after an antecedent hematologic malignancy like MDS, primary myelofibrosis (PMF), or therapy with radiation or chemotherapy [9,14,15]. In a series of 123 patients by AlKali et al, nearly half the cases of hypocellular AML were composed of secondary AML, either with an antecedent hematologic disorder or prior history of chemotherapy or radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Hypocellular acute leukemia: study of clinical and hematological features

et al. 2014

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Hypocellular acute leukemia was previously referred to as smoldering leukemia. This is currently defined as having ≥20 % blasts in peripheral blood or bone marrow with cellularity of less than 20 % in bone marrow biopsy at presentation. Hypocellular variants of acute myeloid leukemia (AML) are commoner than that of acute lymphoid leukemia (ALL). They may pose a diagnostic challenge to the treating clinician and pathologist as they can simulate hypoplastic myelodysplastic syndrome and aplastic anemia. It is of utmost importance to distinguish these overlapping disorders as treatment modalities differ. Details of clinical features, complete blood counts, bone marrow aspirate findings, percentage cellularity, pattern of infiltration in trephine biopsies, and immunophenotyping by flow cytometry or immunohistochemistry were analyzed in cases diagnosed as hypocellular acute leukemia. Hypocellular acute leukemia constituted 2.5 % (8/316) of all diagnosed cases of acute leukemia during the study period. Seven of the eight cases of hypocellular acute leukemia were hypocellular AML while one was hypocellular ALL. Median age of patients was 45 years, with a male:female ratio of 1.7:1. Mean duration of symptoms was 1.2 months, with most common presenting feature being fever. None of the patients except one had an antecedent hematologic disorder or chemotherapy or radiotherapy. Hypocellular acute leukemia is important to recognize from other overlapping disorders. Clinical parameters and laboratory data including immunophenotyping can aid in distinguishing them.

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