Myeloid Sarcoma of the Nasopharynx Mimicking an Aggressive Lymphoma

Raphael, Jacques; Valent, Alexander; Hanna, Colette; Auger, Nathalie; Casiraghi, Odile; Ribrag, Vincent; Botton, Stéphane de; Saada, Véronique

doi:10.1007/s12105-013-0495-3

Cited by 9 publications

(11 citation statements)

References 20 publications

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“…In conclusion, myeloid sarcoma may either occur alone or be accompanied by a hematological disease (19). In either case, it is a comprehensive disease, with rapid development and a poor prognosis.…”

Section: Discussionmentioning

confidence: 97%

“…The incidence of myeloid sarcoma is extremely low (1,18); the exact data is not clear as the disease may be easily misdiagnosed as malignant lymphoma, metastatic cancer and other diseases (8,19). However, the incidence of myeloid sarcoma in AML is 2-9% (8).…”

Section: Discussionmentioning

confidence: 99%

“…Small-blue-round-cell tumors, including neuroblastoma, rhabdomyosarcoma and Ewing's sarcoma, are primarily observed in children, and generally do not express CD43 or MPO, which aids the differential diagnosis from myeloid sarcoma (18,19).…”

Section: Discussionmentioning

confidence: 99%

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The progression of CD56+ myeloid sarcoma: A case report and literature review

Wang

Zheng

et al. 2016

Oncology Letters

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Abstract.The current study presents a case of cluster of differentiation (CD)56 + myeloid sarcoma in a patient that initially presented with skin lesions, and provides evidence for the clinical and differential diagnosis of myeloid sarcoma. The patient of the present case report was a 65-year-old man who was admitted to hospital with a six-month history of bilateral purple-red papules and nodules, which were present on the upper limbs of the patient and had spread over his whole body one month prior to admission to the hospital. Pathological examination demonstrated a diffuse infusion of primitive round cells at the papillary dermis and subcutaneous tissues. The infiltrated cells were 40-60 µm in diameter and morphologically identical. Immunohistochemical examination revealed that the cells expressed myeloperoxidase, CD56, CD43 and T-cell intracytoplasmic antigen. In addition, several cells expressed CD34, and 90% of the cells expressed Ki67. While the majority of cells in myeloid sarcoma do not express CD56, the present case was a myeloid sarcoma that expressed CD56, which is extremely rare. The sarcoma in the present patient progressed rapidly, and the patient died eight months following the onset of disease. Clinicians should be aware of CD56 + myeloid sarcoma, which is easily misdiagnosed and inappropriately treated. Consequently, myeloid sarcoma may have a high malignancy and poor outcome for patients.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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The progression of CD56+ myeloid sarcoma: A case report and literature review

Wang

Zheng

et al. 2016

Oncology Letters

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“…In particular, the literature has focused on the CD13 and CD68 markers for granular monocytic and macrophagic cells, MPO and CD117 markers for myeloid differentiation, lysozyme marker for monocytic lineage, CD43 marker for myeloid cells as well as T cells and B precursors, and CD34 and terminal deoxynucleotidyl transferase (TdT) markers for immature cells (10). Immunohistochemical detection of intracellular MPO, a major constituent of primary granules of neutrophilic myeloid cells, confirms a diagnosis of GS.…”

Section: Discussionmentioning

confidence: 99%

“…Surgery may be a therapeutic option only for tumors, which cause organ dysfunction (11). The role of radiotherapy and AHSCT as a consolidation regimen remains to be clearly established (10,11).…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical patterns in the differential diagnosis of rhinopharyngeal granulocytic sarcoma

et al. 2016

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Abstract. Granulocytic sarcoma (GS) is a rare extramedullary manifestation of acute myeloid leukemia (AML). GS may develop simultaneously to AML or as a relapse of leukemia, particularly following allogeneic hematopoietic stem cell transplant. Subperiosteal bone, lymph nodes and skin are commonly involved, whereas rhinopharyngeal involvement is less common, with only 14 cases reported in the literature. Due to its rarity, rhinopharyngeal GS may lead to diagnostic pitfalls, particularly when it is poorly differentiated or is without concomitant marrow involvement. Thus, immunohistochemical findings play a key role in diagnosis. The current report describes a case of a 53-year-old female suffering from rhinopharyngeal GS and with a history of AML treated with chemotherapy and radiotherapy, focusing on the importance of the immunohistochemical pattern to assess the right diagnosis. Recent studies have demonstrated that the immunophenotype is of utmost importance for the diagnosis of GS. The high expression of myeloperoxidase (MPO) is common in GS; however, ~30% of GSs do not contain MPO. Therefore, the presence of other markers is required to confirm the diagnosis of GS.

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¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

Cunningham

Kohno

2016

American J Hematol

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Extramedullary tumors remain an obstacle to curing more acute leukemia patients. Their incidence is unknown because the presence of occult tumors that contribute to relapse is not routinely sought as in other cancers. No standard approach exists for treating tumors at most sites, apparent clinical response is typically followed by further tumors, and achievement of lengthy remission is uncommon. Body scanning with 18 FDG PET/CT now provides a means to identify the extent of occult tumors that enables directed tumor eradication and a way to evaluate tumor response. To evaluate its potential benefits, analysis was undertaken of 124 published cases scanned after apparent tumors were diagnosed. Clinical and radiologic exams underestimated extent of disease in over half of 100 cases. Among 70 cases that reported scans after various treatments, 70% achieved negative scans. Half relapsed subsequently but disease-free survivals up to 6 years were documented. These reported cases add to our knowledge of extramedullary leukemia in showing that further tumors are more likely than marrow relapse, clinical and radiologic evaluation of response is inadequate, intensive chemotherapy alone generally does not prevent progression and is associated with significant mortality, and tumor-directed plus systemic therapies appears the most effective approach, particularly to AML tumors. This analysis suggests this technology could increase our ability to eradicate all foci of leukemia, and identify tumors responsible for refractory, residual, and relapsed disease.

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Myeloid Sarcoma of the Nasopharynx Mimicking an Aggressive Lymphoma

Abstract: In conclusion few cases of MS involving the nasopharynx have been reported. Its diagnosis is often difficult and should be considered especially when a high index of suspicion is present and the immunophenotype of the malignant haematological cells is not clearly in favour of a lymphoma.

Cited by 9 publications

References 20 publications

The progression of CD56+ myeloid sarcoma: A case report and literature review

The progression of CD56+ myeloid sarcoma: A case report and literature review

Immunohistochemical patterns in the differential diagnosis of rhinopharyngeal granulocytic sarcoma

¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

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Myeloid Sarcoma of the Nasopharynx Mimicking an Aggressive Lymphoma

Abstract: In conclusion few cases of MS involving the nasopharynx have been reported. Its diagnosis is often difficult and should be considered especially when a high index of suspicion is present and the immunophenotype of the malignant haematological cells is not clearly in favour of a lymphoma.

Cited by 9 publications

References 20 publications

The progression of CD56+ myeloid sarcoma: A case report and literature review

The progression of CD56+ myeloid sarcoma: A case report and literature review

Immunohistochemical patterns in the differential diagnosis of rhinopharyngeal granulocytic sarcoma

18FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases

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Product

Resources

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¹⁸FDG‐PET/CT: 21st century approach to leukemic tumors in 124 cases