Unusual coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis: a diagnostic dilemma

Cl, Kuo; Yb, Yu; Wy, Li; Lee, YL

doi:10.1017/s0022215113000285

Cited by 11 publications

(10 citation statements)

References 6 publications

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“…Myeloid sarcoma can occur at almost any location in the body, including multiple, although rare, reports in the sinonasal tract. 45-47 Myeloid sarcomas are usually composed of sheets of mononuclear cells with a high nuclear:cytoplasmic ratio, and may mimic lymphoma or other poorly-differentiated malignant neoplasms of the sinonasal tract. Immunostains are critical for the diagnosis, and most myeloid sarcomas express CD43 and CD68, with variable expression of CD45, CD34, CD117, CD99, TdT, CD33, myeloperoxidase, CD4 and/or lysozyme.…”

Section: Other Hematopoietic Disordersmentioning

confidence: 99%

Hematolymphoid lesions of the sinonasal tract

Crane

Duffield

2016

Seminars in Diagnostic Pathology

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Summary Various hematolymphoid lesions involve the sinonasal tract, including aggressive B, T, and NK-cell neoplasms; myeloid sarcoma; low grade lymphomas; indolent T-lymphoblastic proliferations; and Rosai-Dorfman disease. Differentiating aggressive lymphomas from non-hematopoietic neoplasms such as poorly differentiated squamous cell carcinoma, olfactory neuroblastoma, or sinonasal undifferentiated carcinoma may pose diagnostic challenges. In addition, the necrosis, vascular damage and inflammatory infiltrates which are associated with some hematolymphoid disorders can result in misdiagnosis as infectious, autoimmune or inflammatory conditions. Here, we review hematolymphoid disorders involving the sinonasal tract including their key clinical and histopathologic features.

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Section: Other Hematopoietic Disordersmentioning

confidence: 99%

Hematolymphoid lesions of the sinonasal tract

Crane

Duffield

2016

Seminars in Diagnostic Pathology

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“…In our review, only two cases underwent HSCT including our case, and satisfactory short-term survival was achieved (Prades et al 2002) (Table 1). Considering that 0% (0/5) of the sinonasal MS patients without HSCT achieved no longer than 2-year survival (Ferri et al 2005;Jo et al 2009;Yamamoto et al 2010;Kuo et al 2013;Kieliszak and Cosenza 2015) (Table 1), we hypothesize that effective chemotherapy and followup HSCT are essential for good prognosis. We performed RT as a local treatment.…”

Section: Discussionmentioning

confidence: 88%

“…MS of the paranasal sinuses is very rare, and the clinical and pathological characteristics are therefore not fully understood. In the present study, we summarized and reviewed 10 MS patients, including nine previous cases (Prades et al 2002;Ferri et al 2005;Gorman et al 2009;Jo et al 2009;Yamamoto et al 2010;Kuo et al 2013;Mei et al 2013;Kieliszak and Cosenza 2015;Gupta et al 2017) ( Table 1). The median age was 59.5 years (6-95, mean 54.2) and female-to-male ratio was 4:6.…”

Section: Discussionmentioning

confidence: 99%

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Myeloid Sarcoma of the Paranasal Sinuses in a Patient with Acute Myeloid Leukemia

Suzuki

Harazaki

Morita

et al. 2018

Tohoku J. Exp. Med.

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Myeloid sarcoma (MS) is an uncommon extramedullary malignant tumor, and often represents a subgroup of acute myeloid leukemia (AML). MS of paranasal sinus origin is extremely rare. We report an uncommon case of sinonasal MS associated with AML, who was successfully treated with hematopoietic stem-cell transplantation. A 39-year-old male was admitted with complaints of left nasal obstruction and proptosis. Computed tomography and magnetic resonance imaging identified a left ethmoidal mass involving the maxillary sinus, the orbit, and the skull base. Nasal endoscopic examination detected a whitish homogeneous mass occupying the left nasal cavity. Although accumulation of atypical lymphocytes was suspected based on initial pathological inspection, immunohistochemical analysis showed myeloperoxidase-positive myeloid cells. Together with concomitant leukocytosis (149,000/µL) composed of myeloid blast cells and excess of myeloblasts in the bone marrow, the patient was diagnosed as sinonasal MS with AML with maturation (French-American-British Classification M2). The patient was treated by chemotherapy (remission induction therapy with daunorubicin and cytarabine; salvage chemotherapy with high-dose cytarabine), radiotherapy (30 Gy in 10 fractions) and allogeneic hematopoietic stem-cell transplantation, and followed up for 12 months with no recurrence. Early diagnosis is critical for the best improvement of MS. MS of the paranasal sinuses may easily be misdiagnosed as malignant lymphoma or poorly differentiated carcinoma. Prompt hematological and immunohistological investigations with suspicion of MS are essential for correct diagnosis. Furthermore, we concisely review nine previously reported patients with MS and indicate the importance of hematopoietic stem-cell transplantation for good prognosis.

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“…Isolated myeloid sarcoma in paranasal sinus is exceedingly rare. We have reviewed the literatures in English, only 6 patients with MS involvement in nasal cavity were reported (Table 1) [10][11][12][13][14][15]. Among the patients, only two cases (case 1 and case 5) were isolated MS and the others presented with AML history or synchronous MDS.…”

Section: Discussionmentioning

confidence: 99%

Isolated Myeloid Sarcoma of the Maxillary Sinus: A Case Report and Review of Literature

Young¹

2014

J Cytol Histol

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Myeloid sarcoma is a rare malignant disease defined as extramedullary infiltration of immature myeloid cells and may precede or occur synchronously with acute myeloid leukemia. We reported a 35-year-old male of isolated myeloid sarcoma who presented with symptoms similar to chronic rhinosinusitis initially. Isolated myeloid sarcoma in the paranasal sinuses is exceedingly rare after reviewing the previous literatures. Through proper histological, adequate panels of immunohistochemical stain (positive markers including CD68/KP1, myeloperoxidase, CD 117, CD 99, CD68/PG-M1, lysozyme, CD34, terminal deoxynucleotidyl transferase and negative markers including CD3, CD20, CD45RO and CD79a) and cytogenic study lead to accurate diagnosis. Early intervention with systemic chemotherapy with cytarabine-based regimens is the treatment of choice. The role of chromosomal aberrations and genetic abnormality related to prognosis remain uncertain.

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Unusual coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis: a diagnostic dilemma

Abstract: Coexistence of sinonasal myeloid sarcoma and acute fulminant invasive fungal sinusitis poses an urgent diagnostic and management challenge to clinicians. Timely recognition of this rare comorbid condition is warranted as application of appropriate treatment can save lives.

Cited by 11 publications

References 6 publications

Hematolymphoid lesions of the sinonasal tract

Hematolymphoid lesions of the sinonasal tract

Myeloid Sarcoma of the Paranasal Sinuses in a Patient with Acute Myeloid Leukemia

Isolated Myeloid Sarcoma of the Maxillary Sinus: A Case Report and Review of Literature

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