Uterine Mass and Menorrhagia: A Rare Presentation of Acute Myeloid Leukemia with Arduous Clinical Course

Mishra, Kundan; Muralidaran, Chandrasekaran; Jandial, Aditya; Mittal, Bhagwant Rai; Varma, Subhash

doi:10.4274/balkanmedj.2017.0941

Balkan Med J

2018

DOI: 10.4274/balkanmedj.2017.0941

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Uterine Mass and Menorrhagia: A Rare Presentation of Acute Myeloid Leukemia with Arduous Clinical Course

Kundan Mishra

Chandrasekaran Muralidaran

Aditya Jandial

et al.

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Cited by 5 publications

(7 citation statements)

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“…It can present as a solitary lesion or multifocal lesion [3]. It can be virtually located in any part of the body and when present confer a poor clinical outcome [4]. Common differential diagnosis includes non-Hodgkin's lymphoma, dendritic cell neoplasm, Ewing sarcoma, and melanoma [5].…”

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confidence: 99%

“…Diagnosis depends on morphology, immunohistochemistry and flow cytometry. PET-CT is useful in detecting anatomically hidden GS, planning radiotherapy and assessing the response to therapy [4,6]. The outcome of chemotherapy alone in patients presenting with granulocytic sarcoma is often disappointing.…”

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confidence: 99%

“…3) followed by hematopoietic stem cell transplantation [2]. A favorable risk is attributed to patients with t (8:21), and a good prognosis is expected from chemotherapy alone, but the outcome is significantly poor in the presence of GS even in the presence of t (8;14) and thus necessitates HSCT in complete remission after induction chemotherapy [4,7].…”

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confidence: 99%

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Multiple Granulocytic Sarcomas: A Rare Presentation of Acute Myeloid Leukemia

Mishra

Jandial

Kumar

et al. 2018

Indian J Hematol Blood Transfus

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Dear editor, A 16-year-old boy, presented with gradually progressive, painless swelling over the back for 1-month duration followed by similar swellings over head and chest. He also noticed bulging of the right eyeball with double vision in last 1 week. Clinical examination revealed a thin built and cachexic young boy. He had multiple swellings over scalp (6 9 4 cm), chest wall (8 9 5 cm) and sacrum (5 9 2 cm, 3 9 2 cm) that were firm to hard, non-tender and adherent to the underlying structure (Fig. 1a, c, d). He also had proptosis of the right eye (Fig. 1b). Ocular movements and pupillary reflex were preserved. Rest of the clinical examination was unremarkable. His complete blood count showed, Hemoglobin 138 g/ L, WBC 3.6 9 10 9 /L, and Platelets 260 9 10 9 /L with a normal peripheral blood smear. A Whole-body PET CT showed intense FDG avid lesions corresponding to the clinically apparent sites along with a retro-orbital mass (Fig. 2). The histopathology report of the biopsied tissue from the sacral swelling was suggestive of non-Hodgkin lymphoma. Bone marrow aspiration-biopsy showed 26% MPO negative blast, which was positive for CD13, CD33, CD34, CD38, CD117 and HLA DR and Cytogenetic studies revealed t (8:21) (AML/ETO or RUNX1/ RUNX1T1). Diagnosis of Acute myeloid leukemia with recurrent cytogenetic abnormality t (8:21

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confidence: 99%

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confidence: 99%

See 1 more Smart Citation

Multiple Granulocytic Sarcomas: A Rare Presentation of Acute Myeloid Leukemia

Mishra

Jandial

Kumar

et al. 2018

Indian J Hematol Blood Transfus

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“…Since cytological findings were highly correlated with histological findings with regard to morphological and immunostaining properties in the current case, we emphasize the effectiveness of using immunocytochemistry for cytodiagnosis. Otherwise, a uterine histological sample is required to obtain a reliable diagnosis …”

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confidence: 99%

“…Otherwise, a uterine histological sample is required to obtain a reliable diagnosis. 7,22 In summary, the present case is instructive because it indicates that leukemia relapse can occur solely in the uterus without bone marrow involvement. Furthermore, our observations illustrate that uterine cytology can be useful for diagnosing leukemia.…”

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confidence: 99%

Cytological detection of recurrence of acute myeloid leukemia in a postmenopausal woman presenting with abnormal uterine bleeding

Tamba-Sakaguchi

Oshiro

Minakata

et al. 2018

Diagnostic Cytopathology

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The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

Mishra

Kumar

Ninawe

et al. 2021

Therapeutic Advances in Infection

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Introduction: Acute myeloid leukemia (AML) is the commonest leukemia in adults. Mortality in thew first 30-days ranges from 6% to 43%, while infections account for 30–66% of early deaths. We aim to present our experience of infections in newly-diagnosed AML. Method: This prospective, observational study, was undertaken at a tertiary care hospital in Northern India. Patients with confirmed AML (bone marrow morphology and flow cytometry) and who had developed febrile neutropenia (FN), were included. Result: A total of fifty-five patients were included in the study. The median age of the patients was 47.1 years (12–71) and 28 (50.9%) were males. Fever (33, 60%) was the commonest presentation at the time of diagnosis. One or more comorbid conditions were present in 20 patients (36.36%). Infection at presentation was detected in 17 patients (30.9%). The mean duration to develop febrile neutropenia since the start of therapy was 11.24 days. With each ten-thousand increase in white blood cell (WBC) count, the mean number of days of FN development decreased by 0.35 days ( p = 0.029). Clinical and/or radiological localization was possible in 23 patients (41.81%). Thirty-four blood samples (34/242, 14.04%) from 26 patients (26/55, 47.3%) isolated one or more organisms. Gram negative bacilli (GNB) were isolated in 24 (70.58%) samples. Burkholderia cepacia (8/34, 23.52%) was the commonest organism. The number of days required to develop febrile neutropenia was inversely associated with overall survival (OS). However, when compared, there was no statistically significant difference in OS between patients developing fever on day-10 and day-25 ( p = 0.063). Thirteen patients (23.63%) died during the study period. Discussion: Low percentage of blood culture positivity and high incidence of MDR organisms are a matter of concern. Days to develop febrile neutropenia were inversely associated with overall survival (OS), emphasizing the importance of preventive measures against infections. Conclusion: Infections continues to be a major cause of morbidity and mortality among AML patients.

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Uterine Mass and Menorrhagia: A Rare Presentation of Acute Myeloid Leukemia with Arduous Clinical Course

Cited by 5 publications

References 5 publications

Multiple Granulocytic Sarcomas: A Rare Presentation of Acute Myeloid Leukemia

Multiple Granulocytic Sarcomas: A Rare Presentation of Acute Myeloid Leukemia

Cytological detection of recurrence of acute myeloid leukemia in a postmenopausal woman presenting with abnormal uterine bleeding

The clinical profile, management, and outcome of febrile neutropenia in acute myeloid leukemia from resource constraint settings

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