Blood Res.  2020 Jun;55(2):112-115. 10.5045/br.2020.2019191.

Chronic phase of chronic myeloid leukemia presenting with myeloid sarcoma in an adolescent

• Lee HJ
• Gu MJ
• Kong E
• Lee JM

• KMID: 2503486
• DOI: http://doi.org/10.5045/br.2020.2019191

Figure

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  Fig. 1 Histopathology of the thigh biopsy (A) low-power image (hematoxylin and eosin, ×100) and (B) high-power image (hematoxylin and eosin, ×400) showing medium to large cells with a cleaved nucleus and eosinophilic cytoplasm. (C) Tumor cells are diffusely positive for myeloperoxidase (immunohistochemical stain, ×400).

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  Fig. 2 Initial thigh T2 magnetic resonance image (MRI) showing a 12×6×4 cm sized heterogeneous low signal intensity lesion in the proximal portion of the vastus lateralis muscle (A). Fluorodeoxyglucose (FDG)-positron emission tomography (PET) scan showing high uptake of FDG in the right thigh and diffused uptake in the BM of the entire skeleton (B).

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  Fig. 3 After 6 months of treatment, a significant reduction in tumor size was achieved (A). Barely noticeable tumor seen on the thigh T2 MRI scan. Significant reduction in the extent and intensity of FDG uptake seen on FDG-PET scan (B).

Reference

1. Kawamoto K, Miyoshi H, Yoshida N, Takizawa J, Sone H, Ohshima K. 2016; Clinicopathological, cytogenetic, and prognostic analysis of 131 myeloid sarcoma patients. Am J Surg Pathol. 40:1473–83. DOI: 10.1097/PAS.0000000000000727. PMID: 27631510.

2. Zhou T, Bloomquist MS, Ferguson LS, et al. 2020; Pediatric myeloid sarcoma: a single institution clinicopathologic and molecular analysis. Pediatr Hematol Oncol. 37:76–89. DOI: 10.1080/08880018.2019.1683107. PMID: 31682773.

3. Pilieri SA, Orazi A, Falini B. Swerdlow SH, Campo E, Harris NL, editors. 2008. Myeloid sarcoma. WHO classification of tumours of haematopoietic and lymphoid tissues. 4th ed. IARC Press;Lyon, France: p. 140–1.

4. Chen Z, Wang W, Rich A, Tang G, Hu S. 2015; Myeloid sarcoma as the initial presentation of chronic myelogenous leukemia, medullary chronic phase in era of tyrosine kinase inhibitors: a report of 11 cases. Am J Hematol. 90:E146–8. DOI: 10.1002/ajh.24045. PMID: 25960187.

5. Dasappa L, Thanky AH, Kuntegowdanahalli LC, et al. 2017; Myeloid sarcoma as the first sign of progression of chronic myeloid leukemia in medullary chronic phase: experience from a Tertiary Cancer Centre in Southern India. Gulf J Oncolog. 1:21–5.

6. Chen Z, Wang W, Cortes JE, et al. 2016; Differential clinical and prognostic impact of myeloid sarcoma vs medullary myeloid blast phase of chronic myelogenous leukemia in the era of tyrosine kinase inhibitor therapy. Blood Cancer J. 6:e418. DOI: 10.1038/bcj.2016.27. PMID: 27152845. PMCID: PMC4916296.

7. Samborska M, Derwich K, Skalska-Sadowska J, Kurzawa P, Wachowiak J. 2016; Myeloid sarcoma in children - diagnostic and therapeutic difficulties. Contemp Oncol (Pozn). 20:444–8. DOI: 10.5114/wo.2016.65602. PMID: 28239280. PMCID: PMC5320455.