Granulocytic Sarcoma (GS) as First Manifestation of AML.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4596-4596
Author(s):  
Maged Khalil ◽  
Tamer Malik ◽  
Albeir Mousa ◽  
Madhumati Kalavar ◽  
Richard Fogler ◽  
...  
Keyword(s):  
Chromosomal Abnormalities ◽  
Epigastric Pain ◽  
Gastric Wall ◽  
Pancreatic Head ◽  
Granulocytic Sarcoma ◽  
The Body ◽  
Myelogenous Leukemia ◽  
Wall Thickening ◽  
High Dose ◽  
Extramedullary Tumor

Abstract Granulocytic sarcoma (GS), or chloroma is an extramedullary tumor of immature myeloid cells which occurs throughout the body, often associated with acute myeloid leukemia (AML) or in the accelerated phase of chronic myelogenous leukemia, but rarely as the first manifestation of AML, preceding the onset in marrow and blood by months or years[1, 2] Herein, we report GS of lymph nodes presenting as first manifestation of AML Case Report A 53 years old male presented with recurrent episodes of epigastric abdominal pain without history of trauma or infections, Physical examination was normal. Laboratory examination showed WBC 5.2, ANC 4.4, Hemoglobin 13.6 gm/dl, PLT.306, 000 and Retic 1.8. Computerized Tomography (CT) of abdomen and pelvis showed extensive abdominal and pelvic lymphadenopathy, gastric wall thickening and prominence of the pancreatic head versus peripancreatic lymphadenopathy. Subsequently Esophagogastroduodenscopy and colonoscopy were both negative for malignancy. Peripheral smear showed normal RBC, and no myeloblasts. Laparoscopic retroperitoneal lymph node biopsy revealed granulocytic sarcoma, with immunohistochemistry positive for CD43, CD117, CD68 and MPO Bone marrow biopsy and aspirate were performed, showing increased M: E ratio, increased blasts (29%), with flow cytometry reporting positivity for CD13, CD33, CD34, CD117, and HLA-DR supporting the diagnosis of AML. Chromosomal analysis including Fluorescence in situ hybridization studies (FISH) showed no evidence of chromosomal abnormalities. Patient continued to have epigastric pain radiating to the back without fever, night sweats or weight loss. He was treated with standard induction chemotherapy with Ara-c (7 days) and Idarubicin (3days), resulting in complete remission with resolution of the abdominal and pelvic lymphadenopathy. Patient is currently receiving consolidation therapy with high dose Ara-c Conclusion Granulocytic sarcoma is a rare disease. The overall prognosis is poor. However, AML-type chemotherapy appears to improve survival.

Hematological and toxicological evaluation of formaldehyde as a potential cause of human leukemia

2010 ◽  
Vol 30 (7) ◽  
pp. 725-735 ◽  
Author(s):  
Bernard D Goldstein
Keyword(s):  
Bone Marrow ◽  
Chromosomal Abnormalities ◽  
Species Difference ◽  
The Body ◽  
Myelogenous Leukemia ◽  
Laboratory Animals ◽  
Human Leukemia ◽  
Toxicological Evaluation ◽  
Hematopoietic Stem ◽  
Hematological Cancers

Epidemiological findings suggesting that formaldehyde exposure is associated with a higher risk of acute myelogenous leukemia (AML) and other hematological cancers have led to consideration of the potential mechanism of action by which inhalation of this rapidly reactive agent can cause bone marrow cancer. Two major mechanism-based arguments against formaldehyde as a leukemogen have been the difficulty in envisioning how inhaled formaldehyde might penetrate to the bone marrow; and the lack of similarity of non-cancer effects to other known human myeloleukemogens, particularly the absence of pancytopenia in humans or laboratory animals exposed to high levels. However, both of these arguments have been addressed by the recent finding of a pancytopenic effect and chromosomal abnormalities in heavily exposed Chinese workers which, if replicated, are indicative of a genotoxic effect of formaldehyde on hematopoietic stem cells that is in keeping with other known human leukemogens. Review of the body of evidence suggests an apparent discrepancy between studies in laboratory animals, which generally fail to show evidence of penetration of formaldehyde into the blood or evidence of blood or bone marrow genotoxicity, and studies of exposed humans in which there tends to be evidence of genotoxicity in circulating blood cells. One possible explanation for this discrepancy is species difference. Another possible explanation is that myeloid precursors within the nasal mucosa may be the site for leukemogenesis. However, chloromas, which are local collections of myeloid tumor cells, are rarely if ever found in the nose. Other proposed mechanisms for formaldehyde leukemogenesis are reviewed, and dose issues at the interface between the epidemiological and hematotoxicological findings are explored.

Atypical presentation at acute gastritis: significant gastric wall thickening as a presentation of a primary Helicobacter pylori infection in children

2021 ◽  
Vol 14 (7) ◽  
pp. e243912
Author(s):  
Kiyokuni Nakamura ◽  
Ryo Tamura ◽  
Yoshitomi Yasui ◽  
Hideaki Okajima
Keyword(s):  
Helicobacter Pylori ◽  
Epigastric Pain ◽  
Gastric Wall ◽  
Malignant Tumour ◽  
Wall Thickening ◽  
Atypical Presentation ◽  
Negative Consequences ◽  
Ulcer Disease ◽  
Acute Gastritis ◽  
H Pylori

Helicobacter pylori infection could cause chronic inflammation in the stomach and induce peptic ulcer disease or even malignant tumour. The initial infection of the organism happens in childhood but most of cases are latent. We had a case of 10-year-old girl who presented with acute epigastric pain and significant thickening of the stomach wall on CT. The finding seemed atypical for acute gastritis so oesophagogastroduodenoscopy and serology examination were added and the primary infection of H. pylori was confirmed with the exclusion of other possible diagnoses like eosinophilic gastritis and IgA vasculitis. Acute gastritis is one of the most common sickness in children, however, it would be worthwhile considering further investigation including H. pylori infection in a case of atypical presentation to prevent negative consequences derived from chronic H. pylori infection.

Small cell carcinoma of gall bladder: An uncommon histologic entity

2020 ◽  
Vol 92 (5) ◽  
pp. 1-5
Author(s):  
Amit Gupta ◽  
ROHIK ANJUM ◽  
Rishit Mani ◽  
Navin Kumar ◽  
Anoushika Mehan ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Cell Carcinoma ◽  
Small Cell Carcinoma ◽  
Pancreatic Head ◽  
Small Cell ◽  
The Body ◽  
Wall Thickening ◽  
Main Portal Vein ◽  
Significant Weight Loss ◽  
Upper Abdomen

Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor prognosis in view of its aggressive nature. We here report a case of small cell carcinoma GB 55-year old lady presented with features of obstructive jaundice with significant weight loss. Examination revealed hard lump in right upper abdomen with multiple scratch marks all over the body. Clinically she had jaundice. Blood investigations revealed hyperbilirubinemia. Tumour markers showed raised CA 19-9. Staging CECT thorax and Abdomen reported polypoidal enhancing wall thickening of gall bladder with multiple metastatic deposits close to pancreatic head encasing main portal vein and common bile duct. Histopathology was suggestive of small cell carcinoma. Patient was referred to Oncology department and is receiving palliative cisplatin-etoposide chemotherapy

scholarly journals Granulocytic Sarcoma of the Male Breast in Acute Myeloblastic Leukemia with Concurrent Deletion of 5q and Trisomy 8

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Muhammad Rizwan ◽  
Md. Monirul Islam ◽  
Zia ur Rehman
Keyword(s):  
Myeloid Leukemia ◽  
Granulocytic Sarcoma ◽  
Clinical History ◽  
The Body ◽  
Male Breast ◽  
Prior History ◽  
Trisomy 8 ◽  
Extramedullary Tumor ◽  
History Of ◽  
Improve Patient

We describe a unique case of Granulocytic Sarcoma (GS) in a male, who presented to us with a painless right breast mass without any prior history of Leukemia. GS is an extramedullary tumor of myeloproliferative precursors and may involve multiple sites of the body, but involvement of male breast is extremely rare. In the absence of clinical history or hematological abnormality, GS may be misdiagnosed, depending on the degree of myeloid differentiation present within the tumor. Often it is misdiagnosed as lymphoma. Diagnosis is made by finding eosinophilic myelocytes, myeloperoxidase, chloroacetate esterase staining, and lysozyme immunostain. Chemotherapy regimens similar to acute myeloid leukemia are recommended to treat GS. Recognition of this rare entity is important because early, aggressive chemotherapy can induce regression of the tumor and improve patient longevity.

Granulocytic Sarcoma of the Small Intestine

2006 ◽  
Vol 130 (10) ◽  
pp. 1570-1574 ◽  
Author(s):  
Shane K. Kohl ◽  
Patricia Aoun
Keyword(s):  
Small Intestine ◽  
Correct Diagnosis ◽  
Granulocytic Sarcoma ◽  
Unknown Origin ◽  
Myelogenous Leukemia ◽  
Anatomic Site ◽  
Extramedullary Tumor ◽  
Acute Myelogenous ◽  
Immature Myeloid Cells ◽  
Appropriate Therapy

Abstract Granulocytic sarcoma is an extramedullary tumor of myeloblasts and/or immature myeloid cells, which can develop at any anatomic site and is often a forerunner to the development of acute myelogenous leukemia. Granulocytic sarcoma of the gastrointestinal tract most frequently involves the small intestine and most often presents with abdominal pain and obstruction. Pathologists must consider granulocytic sarcoma in any mass of unknown origin with a diffusely infiltrating population of tumor cells, as the diagnosis is often initially unrecognized, especially in nonleukemic patients. Multiple ancillary modalities are available to assist pathologists in making the correct diagnosis so that appropriate therapy can be initiated.

scholarly journals Primary Localization of a Hydatid Cyst in the Pancreas via Laparoscopic Treatment: A Case Report

2021 ◽  
Author(s):  
Adeleh Hashemi Fard ◽  
Hormoz Hoseinpour Deyrestani ◽  
Hamed Golmohamadi ◽  
Alireza Rezapanah
Keyword(s):  
Hydatid Cyst ◽  
Epigastric Pain ◽  
Rare Event ◽  
Pancreatic Head ◽  
Hepatic Cyst ◽  
The Body ◽  
Partial Cystectomy ◽  
Cystic Neoplasm ◽  
External Drainage ◽  
Pancreatic Lesion

Hydatid disease is mainly because of the Echinococcus granulosus at the larval stage. The liver and lung are its most consequences. The pancreatic hydatid cyst (PHC) incidence is very low (0.14%-2%). A 55- year-old female patient presented with epigastric pain for the last one year that the pain did not continue but during one months ago suffered continually. In physical examination, there was not any abdominal bulb, tenderness and rebound tenderness. A 54×59 mm cystic structure was observed by ultrasonography (USG) and Contrast-enhanced Computed Tomography (CT) in the pancreatic body with stone in the gallbladder. Amylase, lipase, and LFT levels were normal. The Anti-hydatid antibody was positive. During laparoscopic exploration, a hydatid cyst was found. Partial cystectomy with external drainage and cholecystectomy was performed once irrigation with scolicidal agent and evacuation of cystic contents was conducted. Histopathological biopsy reported Hydatid cyst. A pancreatic, hepatic cyst is a rare event. Hematogenous is the most common spread way. Cysts in the pancreatic head could be found with obstructive jaundice. Usually, cysts in the body and tail are known to be asymptomatic. USG, CT, and Hydatid serology are useful with the clinical diagnosis as well as monitoring the recurrence. An exploration via surgery is an option that includes pericystectomy, partial cystectomy with/without external drainage or omentopexy, marsupialization, or cysto-enterostomy, which is done. What makes this case unique is the laparoscopic method that we used instead of open surgery, which is a treatment of choice. The recommendation is pre-operative and postoperative antihelminthic (Albendazole). PHC could be present as pseudocyst or cystic neoplasm of the pancreas. For patients with endemic regions and laparoscopic surgery, differential diagnosis of the cystic pancreatic lesion should be noticed. Common surgery approach could be considered for such patients.

Isolated granulocytic sarcoma: report of a case and review of the literature.

1986 ◽  
Vol 4 (6) ◽  
pp. 912-917 ◽  
Author(s):  
M Eshghabadi ◽  
A M Shojania ◽  
I Carr
Keyword(s):  
Combination Chemotherapy ◽  
Granulocytic Sarcoma ◽  
Myeloproliferative Disorders ◽  
Precursor Cells ◽  
Myelogenous Leukemia ◽  
Partial Mastectomy ◽  
Review Of The Literature ◽  
Initial Manifestation ◽  
Extramedullary Tumor ◽  
The Right

Granulocytic sarcoma (GS) is an extramedullary tumor composed of granulocytic precursor cells. The tumor usually develops during the course of myelogenous leukemia or myeloproliferative disorders and may represent the initial manifestation of leukemia. Rarely, GS is recognized as an isolated tumor without any evidence of leukemia. However, in such cases, leukemia generally develops within 1 to 2 years of the diagnosis of GS. We are reporting a case of a 45-year-old woman who was diagnosed as having an isolated GS of the right breast in August 1980. She was treated with a partial mastectomy followed by 1 year of combination chemotherapy as used in the cases of acute myeloblastic leukemia and has remained free of disease to the present time. That is, she has not developed leukemia or recurrence of GS for 64 months. Based on this experience and on the review of the literature, we recommend that all cases of GS be treated with combination chemotherapy as in cases of acute myeloblastic leukemias.

Helical CT Findings of Gastric Wall Thickening by Peptic Ulcer: Compared with Gastric Adenocarcinoma with Ulcer

2000 ◽  
Vol 42 (2) ◽  
pp. 281
Author(s):  
Won Jung Jung ◽  
Jong Chul Choi ◽  
Keum Soo Seo ◽  
Bon Sik Koo ◽  
Byeong Ho Park ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Gastric Adenocarcinoma ◽  
Gastric Wall ◽  
Helical Ct ◽  
Wall Thickening ◽  
Ct Findings

New Therapeutic Approach to Reduce Methotrexate Toxicity after High-Dose Chemotherapy in a Child with Acute Lymphocytic Leukemia: Efficacy and Safety of Hemoadsorption with HA-230 Adsorber

2021 ◽  
pp. 1-5
Author(s):  
Vitaliy Sazonov ◽  
Zaure Tobylbayeva ◽  
Askhat Saparov ◽  
Bolatbek Jubaniyazov ◽  
Samat Issakov ◽  
...  
Keyword(s):  
Acute Lymphocytic Leukemia ◽  
Pediatric Patients ◽  
High Dose Chemotherapy ◽  
The Body ◽  
Lymphocytic Leukemia ◽  
High Dose ◽  
Successful Implementation ◽  
Efficacy And Safety ◽  
Related Complication ◽  
Dose Methotrexate

Background: High-dose methotrexate (HDMTX) is likely to cause a number of side effects and manifest itself as hepatotoxicity, nephrotoxicity, mucositis, and neurotoxicity. A several studies demonstrated the efficacy of extracorporeal detoxification methods such as plasma exchange, hemodialysis (HD), HD filtration, and hemoperfusion for the treatment of MTX delayed clearance. However, none of the existing methods as effective as expected and limited for general implementation due to a procedure-related complication. Case Report: Here, we report a successful implementation of HA-230 hemoadsorption procedure to remove cumulated MTX from the body and reduce its toxicity in a child with ALL after high-dose chemotherapy. Results and Conclusion: Based on our results, single-hemoadsorption procedure with the HA-230 adsorber in case of delayed methotrexate clearance was safe and well-tolerated in a pediatric patient with ALL and would significantly improve the patient’s condition. Further studies need to demonstrate its safety and efficacy in a large number of pediatric patients.

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