Multiple Granulocytic Sarcomas in Acute Myeloblastic Leukemia with Simultaneous Occurrence of t(8:21) and Trisomy 8

Somjee, S; Borker, Anupama; Gardner, Renée V.; Velez, María

doi:10.3109/10428190109097737

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…Multiple appearances of the lesion with involvement of more than one type of tissue, either concurrently or sequentially, have also been reported. 22 In contrast to the lesion's intradural involvement of the spine in our patient, spinal myeloid sarcomas are usually located extradurally, and may in some cases cause signs and symptoms of spinal cord compression. 3,19 Bone involvement is most frequently seen subperiosteally and is commonly localized in the vertebrae, sternum, orbits, and cranium.…”

Section: Discussioncontrasting

confidence: 52%

Myeloid sarcoma with multiple lesions of the central nervous system in a patient without leukemia

Widhalm

Dietrich

Müllauer

et al. 2006

JNS

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The authors report the unusual case of a 35-year-old woman suffering from left leg numbness and radiculopathy due to multiple lesions in the central nervous system: one right parietal extracranial-intracranial lesion with invasion of the sensory cortex, and two intraspinal, intradural lesions compressing the spinal cord at T3-5 and S 1-4. Biopsy sampling of the extracranial part of the parietal lesion led to a diagnosis of myeloid sarcoma. Further examination revealed no evidence of leukemic disease or myeloproliferative disorder. An aggressive multimodal approach to treatment in this patient with a combination of chemotherapy, whole-body radiotherapy, and allogeneic bone marrow transplantation was started immediately. The patient experienced full neurological recovery and complete disappearance of all lesions. At the 7-year follow-up examination, there was no evidence of disease. To the authors' knowledge, this is the first report of a myeloid sarcoma with both intracranial and intraspinal manifestations in a patient without leukemia.

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Section: Discussioncontrasting

confidence: 52%

Myeloid sarcoma with multiple lesions of the central nervous system in a patient without leukemia

Widhalm

Dietrich

Müllauer

et al. 2006

JNS

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“…Granulocytic sarcoma has been reported in extra-and intracranial locations. 8,33) Intracranial granulocytic sarcoma arises from the hematopoietic tissue of the skull bones and transverses the haversian canals to reach the subperioste-S. Nishimura et al…”

Section: Discussionmentioning

confidence: 99%

“…38) Our patient received systemic chemotherapy and whole neural axis irradiation, and achieved complete remission. Although surgical excision remains controversial, 26,33,36,38) we think there is no advantage following chemotherapy and irradiation, except in the presence of progressive neurological deficits such as increasing intracranial pressure or disturbance of consciousness which are uncontrollable by the conservative treatment. Surgery would increase the risk of infection and central nervous system dissemination.…”

Section: Discussionmentioning

confidence: 99%

Isolated Recurrence of Granulocytic Sarcoma Manifesting as Extra- and Intracranial Masses

Nishimura

Kyuma

Kamijo

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 30-year-old female presented with a rare case of isolated recurrence of granulocytic sarcoma manifesting as extra-and intracranial masses 16 months after successful treatment of acute myeloblastic leukemia (M-2). She presented with a swelling located on her forehead that had appeared just after hitting her forehead, and never diminished in size. The mass was elastic hard and not freely mobile. Computed tomography and magnetic resonance imaging demonstrated enhanced masses in the right frontal extra-and intracranial region with no bone destruction. There was no evidence of relapse in the bone marrow. Needle aspiration biopsy of the subscalpal mass was performed. Fluorescence in situ hybridization revealed AML1/MTG8 fusion gene associated with t(8; 21). Two courses of systemic chemotherapy with high-dose cytarabine and total neural axis irradiation resulted in complete remission.

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“…The most frequent is t(8;21)(q22;q22), occurring in some patients with acute myeloblastic leukemia [4,11,32]. One case report noted the simultaneous occurrence of t(8;21) and trisomy 8 [3]. Acute myelomonoblastic leukemia can also be associated with eosinophils and can have either the gene sequence inv(16)(pI3;q22) or t(16;16)(pl3;q22) [33].…”

Section: Geneticsmentioning

confidence: 92%

Myeloid Sarcoma: Clinical and Morphologic Criteria Useful for Diagnosis

Audouin

Comperat²,

Tourneau³

et al. 2003

Int J Surg Pathol

117

107

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Extramedullary accumulation of myeloblasts or immature myeloid cells form tumors called myeloid sarcoma in the WHO classification. Such tumors develop in lymphoid organs, bone (skull, orbit, etc.), skin, soft tissue, various mucosae and organs, and the CNS. They may precede or occur concurrently with acute myeloid leukemia, or reveal blastic transformation of chronic myeloproliferative disorders or myelodysplastic syndromes. They may also reveal relapses in treated patients. They are constituted by a diffuse infiltrate made up of medium-to-large cells. The cells are difficult to identify. Imprints are very useful. Immunohistochemistry can help diagnose and distinguish four variants: granulocytic myeloperoxidase (MPO+, CD 68+ [KP1+/-, PGM1-] lysozyme+, CD 34+/-), monoblastic (MPO-, CD 68+, [KP1+, PGM1+] lysozyme+, CD 34-), myelomonoblastic (MPO-, CD 68+, [KP1+, PGM1+] lysozyme+, CD 34-), or megakaryoblastic (positivity for factor VIII, CD 61, CD 31). Immunohistochemistry sometimes demonstrates expression of CD 43, CD 7, CD 79a, and CD 56 (particularly the monoblastic variant with t[8;21]). Recently the demonstration of CD 99 and CD 117, which can now be done on paraffin sections, may be useful to identify blasts of granulocytic origin. The diagnosis is missed in about 50% of cases when immunohistochemistry is not used. Patients with myeloid sarcomas should be treated in the same way as patients with acute myeloblastic leukemia. Disease progression and prognosis are similar for the two conditions.

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Multiple Granulocytic Sarcomas in Acute Myeloblastic Leukemia with Simultaneous Occurrence of t(8:21) and Trisomy 8

Cited by 14 publications

References 21 publications

Myeloid sarcoma with multiple lesions of the central nervous system in a patient without leukemia

Myeloid sarcoma with multiple lesions of the central nervous system in a patient without leukemia

Isolated Recurrence of Granulocytic Sarcoma Manifesting as Extra- and Intracranial Masses

Myeloid Sarcoma: Clinical and Morphologic Criteria Useful for Diagnosis

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