Myeloid sarcoma of the breast in an aleukemic patient: a rare entity in an uncommon location (original) (raw)
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Myeloid sarcoma involving the breast
Collegium antropologicum, 2010
Myeloid sarcoma is a tumor mass with extramedullary growth pattern, composed of myeloblasts or immature myeloid cells. The development of myeloid sarcoma may precede or concur with acute or chronic myeloid leukemia (AML or CML) or other myeloproliferative diseases or myelodysplastic syndromes (MDS). Isolated myeloid sarcoma of the breast is very rare. A case is presented of a 25-year-old, previously healthy woman that presented to our department for a palpable node, 5 x 2 cm in size, in the upper medial quadrant of her left breast. Fine needle aspiration (FNA) produced a sample consisting of medium sized blasts. Additional work-up revealed anemia, thrombocytopenia and leukocytosis, along with atypical blasts detected in peripheral blood and bone marrow smear. Based on the morphology, cytochemical characteristics and immature cell immunophenotype, it was considered a case of acute myeloid leukemia without maturation. In spite of intensive chemotherapy, the patient died within a year ...
Primary Myeloid Sarcoma of the Breast: A Case Report and Review of Literature
Journal of Microscopy and Ultrastructure, 2018
Myeloid sarcoma (MS) of the breast is uncommon. We report this case of a 29-year-old female presented with a breast lump that was diagnosed as hamartoma by radiology. The lump was removed surgically. Pathological examination revealed a malignant tumor composed of immature cells with eosinophilic cytoplasm and single or multiple nucleoli, diffusely infiltrating the mammary parenchyma and sparing a few ducts and lobules. Immunostaining revealed positivity for leukocytic common antigen, myeloperoxidase, and CD68, and focally positive for CD34 and CD117. The final diagnosis was released as primary MS of the breast. The patient was treated with radiotherapy and chemotherapy. Three consecutive bone marrow biopsies were negative for neoplastic infiltration.
Myeloid sarcoma: a report of four cases at unusual sites
German medical science : GMS e-journal, 2017
Background: Myeloid sarcoma (MS) or granulocytic sarcoma is a rare tumor consisting of myeloid blasts with or without maturation occurring at anatomic sites other than the bone marrow. MS can involve any organ system but shows a predilection for skin, bone, and soft tissues of head and neck region. Case report: We report four cases of MS occurring at unusual sites, out of which three were de novo and one was associated with acute myeloid leukemia (AML). Conclusion: Although MS is associated with AML, it can rarely present without any existent hematologic disease. Differential diagnosis of a soft tissue mass should include MS even in the absence of leukemia. Establishment of the correct diagnosis depends on morphologic, histochemical, and immunohistochemical examination.
Myeloid Sarcoma – a Clinicopathological Analysis of 25 Cases
Journal of Evidence Based Medicine and Healthcare
INTRODUCTION Myeloid sarcoma (MS) is defined as "a tumour mass consisting of myeloid blasts with or without maturation, occurring at an anatomical site other than bone marrow". It rarely arises as the only lesion, referred to as primary myeloid sarcoma. Secondary myeloid sarcomas precede or develop concomitantly with acute myeloid leukaemia (AML), myelodysplastic syndrome (MDS), myeloproliferative neoplasm (MPN) or MDS/MPN. MS developing in a known patient of AML is considered as relapse irrespective of blood and bone marrow findings. This study retrospectively analyses the clinicopathological, morphological and immunohistochemical profiles along with available data on cytogenetics and followup of 25 patients diagnosed as myeloid sarcoma in a regional cancer centre in South India. MATERIALS AND METHODS All cases diagnosed histopathologically as myeloid sarcoma between 2006 and 2015 were retrieved from the archives of the department of pathology. The clinicopathological profile of these cases was reviewed, including age, sex, site of involvement and accompanying haematological findings. Immunohistochemical and cytogenetic findings were noted along with laboratory data and median survival time. RESULTS Of the 25 cases studied, 18 patients were male and 7 patients were female. The age ranged from 14 months to 65 years. The commonest site of involvement was lymph node followed by bone, skin and soft tissue. Twenty cases represented primary MS and the remaining five cases were secondary myeloid sarcomas. Of the latter, four cases were associated with AML and one with chronic myeloid leukaemia (CML). One case of primary lesion in the radius subsequently developed another lesion in calcaneum after 3 years. Trisomy 8 was the commonest cytogenetic abnormality seen. Two patients of the series are alive and on treatment whereas 7 patients died within a year of diagnosis and the remaining were lost to followup. CONCLUSION Myeloid sarcoma is a rare disease with a higher incidence in males. It was seen more commonly as an isolated lesion in our study involving the lymph nodes. It requires early diagnosis and appropriate management including bone marrow transplantation, considering the high mortality.
Acute myeloid leukemia with t(8;21)(q22;q22) preceded by breast granulocytic sarcoma
Revista Brasileira de Hematologia e Hemoterapia, 2008
Granulocytic sarcoma (GS) is a rare extramedullary tumor mass composed of immature cells derived from the hematopoietic myeloid series. It is usually associated with leukemia and other myeloproliferative disorders but can also occur without overt hematologic diseases. The breast has been reported to be an uncommon site of presentation. We report a case of acute myeloid leukemia preceded by GS of the breast. The immunohistochemistry revealed myeloperoxidase, CD68 and CD43 positivity, thus indicating a diagnosis of GS. Conventional cytogenetic analysis of peripheral blood cells showed t(8;21)(q22;22). Complete remission was achieved with Daunorubicin and Cytarabine induction therapy followed by three courses of high-dose Cytarabine consolidation. The patient remains in continuous complete remission at 27 months.
Granulocytic sarcoma of breast: an aleukemic presentation
Indian Journal of Medical Sciences, 2007
Granulocytic sarcoma is a rare extramedullary tumor composed of immature myeloid cells. It is usually associated with leukemia or other myeloproliferative disorders but can also occur without overt hematologic diseases. The breast is an uncommon site of presentation and requires a high index of suspicion for diagnosis. We report such a case in a 45-year-old female, who presented with nontender left breast lump of 6 months' duration. A peripheral smear and bone marrow examination at that time was normal. A lumpectomy was done. An H and E diagnosis of lobular carcinoma vs. non-Hodgkin's lymphoma was entertained. Immunostains, however, revealed myeloperoxidase, naphthol AS-D chloroacetate esterase and CD43 positivity, indicating a diagnosis of granulocytic sarcoma. It appears that early initiation of systemic AMLtype chemotherapy is beneficial and may delay or avert the development of AML in bone marrow and blood. Eight months later, the patient presented with an orbital mass; bone marrow and peripheral smear involvement by AML.
Myeloid Sarcoma: Clinicopathologic, Cytogenetic, and Outcome Analysis of 21 Adult Patients
Leukemia Research and Treatment, 2011
Myeloid sarcoma (MS) is a neoplasm of immature granulocytes, monocytes, or both involving any extramedullary site. Twenty one patients with MS at diagnosis who were treated at King Hussein Cancer Center in Jordan were included in this retrospective study with a male to female ratio of 2 : 1. The most common site was the reticuloendothelial system. The most common morphology subtype was M2 (38%) and the most frequent chromosomal abnormality was trisomy 8. Twenty patients received induction chemotherapy; only 14 (70%) achieved complete remission. Median survival time was 24.7 months for the whole group and 58.6 months for patients who underwent allogenic bone marrow transplant. This paper showed that MS has frequent M2 morphology, carries chromosomal aberrations other than t(8;21), and requires aggressive therapy as a front line approach.
Hematology (Amsterdam, Netherlands), 2017
Myeloid sarcoma (MS) is characterized by extramedullary infiltration by immature myeloid cells. Owing to rarity of this disease, the clinical features and overall outcomes are yet to be clarified. To define clinical characteristics, epidemiology, pathologic findings, treatment options and outcomes in MS. We conducted a retrospective review of 23 patients diagnosed with MS at our institute over a period of 13 years (2002-2015). MS presented mostly as a manifestation of relapsed acute myeloid leukemia, seen in 39% of patients. Skin and subcutaneous soft tissues were the most common sites of anatomic involvement (69.5%). Ninety five percent (n = 19) were positive for classical myeloid markers with either cytochemical staining (chloracetate-esterase, MPO), flow-cytometry (CD33, CD34, CD13 and CD117), or immunohistochemistry (CD34, CD43, CD68 and lysozyme). Of these, 52% were positive for CD33 (n = 12), 35% for CD68 (n = 8), 30% for CD34 (n = 7), and 26% for lysozyme (n = 6). Cytogenetic...