The first case of acute myeloid leukaemia/myeloid sarcoma with cytokeratin expression on blasts diagnosed on urine specimen

AbstractObjective:We report a rare case of concurrent myeloid sarcoma and acute fulminant invasive fungal sinusitis in a patient with relapsed acute myeloid leukaemia.Case report:A 73-year-old man was diagnosed with acute myeloid leukaemia and developed relapse one year later. After two courses of azacytidine, he began suffering from a dull pain in the left temporal and orbital regions. Sinus computed tomography showed a localised lesion in the left ethmoid sinus, which rapidly progressed to an extensive intracranial mass within one month. Surgical debridement was performed, and histopathological analysis revealed the coexistence of myeloid sarcoma and acute fulminant invasive fungal sinusitis. The patient responded well to prompt surgical debridement, antifungal medication and radiotherapy.Conclusion: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.

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Myeloid sarcoma of the vulva as the initial presentation of acute myeloid leukaemia

British Journal of Dermatology ◽

10.1111/bjd.14063 ◽

2015 ◽

Vol 174 (1) ◽

pp. 234-236 ◽

Cited By ~ 5

Author(s):

S.C.‐S. Hu ◽

W.‐T. Chen ◽

G.‐S. Chen

Keyword(s):

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Myeloid Sarcoma ◽

Initial Presentation ◽

Acute Myeloid

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A Relapsing Meningeal Acute Myeloid Leukaemia FLT3-ITD+ Responding to Gilteritinib

Chemotherapy ◽

10.1159/000518356 ◽

2021 ◽

pp. 1-5

Author(s):

Salvatore Perrone ◽

Elettra Ortu La Barbera ◽

Federica Viola ◽

Elena Cipollone ◽

Maria Cristina Scerpa ◽

...

Keyword(s):

Bone Marrow ◽

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Residual Disease ◽

Complete Response ◽

Myeloid Sarcoma ◽

Leg Pain ◽

Magnetic Resonance Imaging Mri ◽

The Right ◽

Acute Myeloid

A patient with a therapy-related acute myeloid leukaemia (AML), NPM1<sup>mut</sup>, and FLT3-ITD+ was treated with induction and consolidation with CPX-351, obtaining a complete response (CR) but minimal residual disease persisted positive. Later, she complained progressive burning leg pain, weakening of the right hand and leg muscles, associated with absence of osteotendinous leg reflexes. Examination of cerebrospinal fluid (CSF) showed a meningeal relapse of AML. Moreover, a magnetic resonance imaging (MRI) showed 2 right meningeal implants of myeloid sarcoma and bone marrow revealed haematologic relapse of disease. She was treated with medicated lumbar punctures (LPs) followed by an FLA-Ida scheme, and she achieved a 2nd CR. Unfortunately, the patient developed hyperleucocytosis and reappearance of meningeal myeloid sarcoma at MRI. For this reason, a monotherapy with gilteritinib (an FLT3 inhibitor) was started: after 3 months of therapy, central nervous system (CNS)-disease shrunken and then faded, while AML in the bone marrow achieved only a partial response. This is the 1st report of a positive biological effect of gilteritinib on CNS (meningeal) myeloid sarcoma. There are no studies of gilteritinib concentration into CSF and penetration of gilteritinib into the blood-brain barrier should be further studied, given the paucity of drugs active on CNS relapse of AML. In patients receiving CPX-351 only, diagnostic LP should be considered after induction.

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Myeloid Sarcoma of the Uterine Cervix as Presentation of Acute Myeloid Leukaemia after Treatment with Low-Dose Radioiodine for Thyroid Cancer: A Case Report and Review of the Literature

Case Reports in Oncology ◽

10.1159/000191215 ◽

2009 ◽

Vol 2 (1) ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Anne Sophie Weingertner ◽

Marc Wilt ◽

Ihab Atallah ◽

Cécile Fohrer ◽

Laurent Mauvieux ◽

...

Keyword(s):

Thyroid Cancer ◽

Case Report ◽

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Uterine Cervix ◽

Low Dose ◽

Myeloid Sarcoma ◽

Review Of The Literature ◽

Acute Myeloid

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Myeloid Sarcoma of the Orbit Preceding Acute Myeloid Leukaemia: A Diagnostic Challenge

Global Journal of Health Science ◽

10.5539/gjhs.v11n14p98 ◽

2019 ◽

Vol 11 (14) ◽

pp. 98

Author(s):

Oluomachi Charity Nnachi ◽

Robert Azu Nnachi ◽

Innocent Paul Ezenwenyi ◽

Ogah Emeka Onwe ◽

Augustine Ejike Okoye ◽

...

Keyword(s):

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Clinical Condition ◽

Tumour Progression ◽

Correct Diagnosis ◽

Myeloid Sarcoma ◽

Initial Presentation ◽

Orbital Mass ◽

Management Of Complications ◽

Acute Myeloid

Objective: Myeloid sarcoma is a rare form of acute myeloid leukaemia characterized by extramedullary proliferation of myeloid blasts which can occur as an isolated lesion in any organ. Even rarer it may occur in the orbit as the initial presentation without a leukaemic phase and diagnosis may be challenging when it is not suspected.           Methods: We report a case of orbital myeloid sarcoma as the initial presentation of acute myeloid leukaemia in an adult who was misdiagnosed and treated as a case of a pseudotumour with resultant significant disease progression and worsening of the clinical condition. There was a lag of four months from the onset of eye mass to the development of acute myeloid leukaemia. Result: Due to patients worsening condition and tumour progression, a repeat biopsy for a second histology opinion at a different facility, immunophenotyping and immunohistochemistry were employed to arrive at the correct diagnosis. Following chemotherapy, the orbital mass reduced markedly and clinical condition improved. The patient was indigent and could not sustain further funding of his treatment because he had already spent much on for management of complications he developed before a definitive diagnosis could be made. Conclusion: Myeloid sarcoma can present as an orbital mass without a leukemic disease. Therefore a high index of suspicion, meticulous examination of biopsy, immunohistochemistry and collaboration between oncologists and ophthalmologists, are required to arrive at an early accurate diagnosis.

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Cytoplasmic nucleophosmin in myeloid sarcoma occurring 20 years after diagnosis of acute myeloid leukaemia

The Lancet Oncology ◽

10.1016/s1470-2045(06)70661-1 ◽

2006 ◽

Vol 7 (4) ◽

pp. 350-352 ◽

Cited By ~ 16

Author(s):

Niccolò Bolli ◽

Sara Galimberti ◽

Maria P Martelli ◽

Alessia Tabarrini ◽

Giovanni Roti ◽

...

Keyword(s):

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Myeloid Sarcoma ◽

Acute Myeloid

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Acute Myeloid Leukaemia Diagnosed by Intra-Oral Myeloid Sarcoma. A Case Report

Head and Neck Pathology ◽

10.1007/s12105-010-0163-9 ◽

2010 ◽

Vol 4 (2) ◽

pp. 132-135 ◽

Cited By ~ 21

Author(s):

Mattheos K. Papamanthos ◽

Alexandros E. Kolokotronis ◽

Haralampos E. Skulakis ◽

Angela-Monika A. Fericean ◽

Matina T. Zorba ◽

...

Keyword(s):

Case Report ◽

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Myeloid Sarcoma ◽

Acute Myeloid

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NEONATAL ACUTE MYELOID LEUKAEMIA

INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY ◽

10.24293/ijcpml.v19i3.417 ◽

2016 ◽

Vol 19 (3) ◽

pp. 211

Author(s):

Luh Putu Rihayani Budi ◽

Ketut Ariawati ◽

Sianny Herawati

Keyword(s):

Bone Marrow ◽

Acute Myeloid Leukaemia ◽

Myeloid Leukaemia ◽

Complete Blood Count ◽

Signs And Symptoms ◽

Peripheral Blood Smear ◽

Monocytic Differentiation ◽

First Case ◽

Leukaemic Cells ◽

Acute Myeloid

Acute myeloid leukaemia (AML) is a. malignant, clonally disease that involves proliferation of blasts in bone marrow, blood, or other tissue. The blasts most often show myeloid or monocytic differentiation. The incidence of AML increases with age, but when neonatal leukaemia does occur, it is paradoxically AML rather than ALL. All the signs and symptoms that present on patient with AML are caused by the infiltration of the bone marrow with leukaemic cells and resulting failure of normal haematopoiesis. Without the normal haematopoietic elements, the patient is at risk for developing life-threatening complications of anaemia, infection due to functional neutropenia, and haemorrhage due to thrombocytopenia. Organomegaly is seen in approximately half of patient with AML due to hepatic and sphlanic infiltration with leukaemic blasts. Prognosis of neonatal leukaemia is poor with the 6-month survival rate is only one third despite aggressive chemotherapy. It has higher mortality rate than any other congenital cancer. The researchers reported two of AML diagnosed cases in neonatal period. The first case, a one-day-old male was referred with respiratory distress and suspect Down syndrome with spontaneous petechiae. The second case, a 17-day-old female presented with bloody diarrhoea and history of hypothyroid. Dysmorphic face and hepatosplenomegalia were found in both of the physical examination. Their complete blood count revealed leukocytosis and thrombocytopenia. Peripheral blood smear revealed myeloblast 30% on the first case and 23% on the second case. Both immunophenotyping revealed the population of blast expressing myeloid lineage (CD33 and CD34).

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