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Li SH, Yang CX, Xing XM, Gao XR, Lu ZY, Ji QX. Myeloid sarcoma with maxillary gingival swelling as the initial symptom: A case report and review of literature. World J Clin Cases 2024; 12:3985-3994. [PMID: 38994293 PMCID: PMC11235421 DOI: 10.12998/wjcc.v12.i19.3985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 04/25/2024] [Accepted: 05/07/2024] [Indexed: 06/29/2024] Open
Abstract
BACKGROUND Myeloid sarcoma (MS), also referred to as granulocytic sarcoma or chloroma, is a rare type of extramedullary malignant tumor. MS comprises primitive granulocytic precursor cells that play a key role in the early stages of white blood cell development. Notably, the occurrence of this tumor in the gingiva is rare. CASE SUMMARY The present study reported the case of MS with gingival swelling in the maxillary region, with aleukemic presentation in a 32-year-old male patient. Following two courses of chemotherapy, computed tomography of the region demonstrated complete clearance of the tumor. At the 12-month follow-up appointment, the patient was in a stable condition with the absence of progression. The etiology, clinical features, diagnosis, and relevant treatment of MS are discussed in the present study. CONCLUSION Diagnosis of MS may be confirmed following histological and immunohistochemical examinations.
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Affiliation(s)
- Shu-Han Li
- Department of Periodontology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Periodontology, School of Stomatology of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Cai-Xiu Yang
- Department of Periodontology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Periodontology, School of Stomatology of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Xiao-Ming Xing
- Department of Pathology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
| | - Xiang-Ru Gao
- Department of Periodontology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Periodontology, School of Stomatology of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Zhao-Yu Lu
- Department of Periodontology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Periodontology, School of Stomatology of Qingdao University, Qingdao 266000, Shandong Province, China
| | - Qiu-Xia Ji
- Department of Periodontology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
- Department of Periodontology, School of Stomatology of Qingdao University, Qingdao 266000, Shandong Province, China
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Wang D, He K, Sroussi H, Treister N, Luskin M, Villa A, Woo SB, Shazib MA. Oral myeloid sarcoma as an uncommon manifestation of acute myeloid leukemia: A case series and review of the literature. J Am Dent Assoc 2021; 152:393-400.e8. [PMID: 33926625 DOI: 10.1016/j.adaj.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 12/13/2020] [Accepted: 01/31/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND OVERVIEW Oral myeloid sarcoma (MS) is an extramedullary tumor that can occur in the setting of acute myeloid leukemia, either as the first sign of an underlying disease or later in the course of disease. The authors' aim was to present the clinical features of oral MS and review the literature. CASE DESCRIPTION Case 1 was an 82-year-old woman with an asymptomatic erythematous swelling on the maxillary gingiva and no history of hematologic malignancy. Case 2, a 65-year-old man, and case 3, a 58-year-old woman, each had a history of acute myeloid leukemia and a painful ulcer on the palatal mucosa and an asymptomatic ulcer on the lower lip mucosa, respectively. Case 1 was treated with focal radiation then chemotherapy and achieved complete remission initially, but died of relapse 2 years after diagnosis. Case 2 received radiotherapy and immunotherapy and had a complete response. Case 3 received chemotherapy and achieved remission initially, but relapsed and is undergoing investigational targeted therapies. CONCLUSIONS AND PRACTICAL IMPLICATIONS Oral MS can manifest as gingival or mucosal swelling or ulceration and can indicate onset or relapse of associated hematologic malignancies, which often have a poor prognosis. Because patients with oral findings are likely to seek treatment from their dentists first, oral clinicians should maintain a broad differential diagnosis list when evaluating oral lesions, especially if treatment prescribed for a more common diagnosis fails to resolve the lesion.
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Hu YG, Deng XH, Lei W, Li XL. Clinical characteristics and management of primary granulocytic sarcoma of the oral cavity: A case report and literature review. Medicine (Baltimore) 2020; 99:e22820. [PMID: 33120806 PMCID: PMC7581149 DOI: 10.1097/md.0000000000022820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Granulocytic sarcoma (GS) is a commonly occurring tumor comprising immature myeloid cells, which are usually related to acute or chronic myelocytic leukemia. The tumor rarely precedes leukemia without bone marrow involvement and is called primary GS. Although primary GS can occur in any body part, the involvement of the oral cavity is uncommon. PATIENT CONCERNS A 49-year-old woman hospitalized at the Department of Plastic and Maxillofacial Surgery presented with a growing mass in her left maxillary hard palate dating two months back. No obvious physical findings were noted during general examination. She was diagnosed with an oral ulcer at a local clinic, and received antibiotics. However, the symptoms did not improve; the mass became bigger and painful. DIAGNOSIS An incisional biopsy of the oral mass was performed, the immunohistochemistry showed that the tumor cells tested positive for myeloperoxidase, CD4, BCL-2, KI-67. Bone marrow aspiration was negative for malignant cells, and the laboratory test results revealed only monocytosis. Standard bone marrow cytogenetic analysis showed a normal karyotype and leukemia-related fusion gene detection was normal. Therefore, the final diagnosis was intraoral primary GS. INTERVENTIONS The patient was treated with a chemotherapy regimen based on idarubicin and cytarabine arabinoside. OUTCOMES After 2 cycles of idarubicin and cytarabine arabinoside regimen chemotherapy, the patient achieved complete remission. The tumor was barely visible in the left maxillary hard palate. There has been no evidence of disease spread and progression after 1 year of follow-up. CONCLUSIONS Careful morphological and immunohistochemical analyses, correlating with clinical data are necessary to establish the diagnosis of oral primary GS. Early aggressive systemic chemotherapy can effectively relieve symptoms, significantly reducing primary GS conversion into acute myelocytic leukemia and prolonging overall survival.
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Affiliation(s)
- Yun-Gang Hu
- Department of Plastic and Maxillofacial Surgery, The People's Affiliated Hospital of Nanchang University
| | - Xiao-Hua Deng
- Department of Plastic and Maxillofacial Surgery, The People's Affiliated Hospital of Nanchang University
| | - Wei Lei
- Department of Plastic and Maxillofacial Surgery, The People's Affiliated Hospital of Nanchang University
| | - Xiao-Lin Li
- Key Laboratory of Maxillofacial Plastic and Reconstructive surgery, Jiangxi, People's Republic of China, 92 Aiguo road, Nanchang, Jiangxi, People's Republic of China
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Guo L, Chen L, Wang H. CD45 correlates with adverse risk stratification, decreased treatment response and unfavorable survival profiles in elderly acute myeloid leukemia patients. Cancer Biomark 2018; 23:455-463. [DOI: 10.3233/cbm-181602] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Nunes LFM, Rocha AL, Magalhães GHR, de Melo FHC, Travassos DV, Mesquita RA, Silva TA. Intraoral granulocytic sarcoma as a manifestation of myelofibrosis: A case report and review of the literature. SPECIAL CARE IN DENTISTRY 2018; 38:409-420. [DOI: 10.1111/scd.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/09/2018] [Accepted: 07/13/2018] [Indexed: 12/25/2022]
Affiliation(s)
| | - Amanda Leal Rocha
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Gustavo Henrique Romani Magalhães
- Department of Hematology and Oncology; Ambulatory of Chronic Myeloproliferative Diseases; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | | | - Denise Vieira Travassos
- Department of Community and Preventive Dentistry; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
| | - Tarcília Aparecida Silva
- Department of Oral Surgery and Pathology; Faculty of Dentistry; Universidade Federal de Minas Gerais; Minas Gerais Brazil
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Gaal A, Chisholm KM, Egbert M. How Rare Is an Oral Presentation of Myeloid Sarcoma in the Infant? J Oral Maxillofac Surg 2018; 76:561-568. [DOI: 10.1016/j.joms.2017.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/26/2017] [Accepted: 08/26/2017] [Indexed: 10/18/2022]
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Shen Y, Zhao L, Wu Y, Huang P. Multifocal occurrence of intraoral isolated MS in a patient without leukemic presentation: A case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:e42-e48. [DOI: 10.1016/j.oooo.2017.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/27/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
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de Andrade BAB, Farneze RDB, Agostini M, Cortezzi EB, Abrahão AC, Cabral MG, Rumayor A, Romañach MJ. Myeloid sarcoma of the oral cavity: A case report and review of 89 cases from the literature. J Clin Exp Dent 2017; 9:e1167-e1171. [PMID: 29075423 PMCID: PMC5650223 DOI: 10.4317/jced.53935] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 07/12/2017] [Indexed: 11/14/2022] Open
Abstract
Myeloid sarcoma is a tumor mass of immature myeloid or granulocytic cells that affects extramedullary anatomic sites, including uncommonly the oral cavity. A 24-year-old female was referred for evaluation of a fast growing painful gingival swelling lasting 2 weeks, associated with fever, fatigue, and cervical lymphadenopathy. Intraoral examination showed a bluish swelling on the right posterior lower gingiva exhibiting necrotic surface. Incisional biopsy of the gingival lesion displayed diffuse infiltration of undifferentiated tumor cells with granulocytic appearance, strongly immunopositive for CD99, myeloperoxidase and Ki-67 (60%), and negative for CD20, CD3, CD34 and TdT. Blood tests presented a severe pancytopenia, and genetic analysis confirmed the diagnosis of acute promyelocytic leukemia. The final diagnosis was of oral myeloid sarcoma associated with acute promyelocytic leukemia with t(15;17). The patient was submitted to chemotherapy but died of the disease one month later. The clinicopathologic and immunohistochemical features of the present case are compared with the 89 cases of oral myeloid sarcoma previously reported in the English-language literature.
Key words:Myeloid sarcoma, chloroma, granulocytic sarcoma, gingiva, oral, acute promyelocytic leukemia, acute myeloid leukemia.
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Affiliation(s)
- Bruno-Augusto-Benevenuto de Andrade
- DDS, PhD, Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Renan-de Barros Farneze
- DDS, MSc, Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Michelle Agostini
- DDS, PhD , Oral Medicine, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Ellen-Brilhante Cortezzi
- DDS, PhD , Oral Medicine, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline-Corrêa Abrahão
- DDS, PhD, Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Marcia-Grillo Cabral
- DDS, PhD, Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Alicia Rumayor
- DDS, PhD, Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (FOP-UNICAMP), Piracicaba, Brazil
| | - Mário-José Romañach
- DDS, PhD, Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Berger GK, Gee K, Votruba C, McBride A, Anwer F. Potential application and prevalence of the CD30 (Ki-1) antigen among solid tumors: A focus review of the literature. Crit Rev Oncol Hematol 2017; 113:8-17. [PMID: 28427526 DOI: 10.1016/j.critrevonc.2017.02.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/26/2017] [Accepted: 02/15/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND CD30 (Ki-1) is a cell membrane protein derived from the tumor necrosis factor (TNF) receptor family. The CD30 antigen has been associated primarily with Hodgkin lymphoma (HL) and systemic anaplastic large cell lymphoma (sALCL). Brentuximab vedotin (BV) is an antibody-drug conjugate targeting the CD30 antigen. FDA approval for BV includes relapsed and refractory HL and sALCL. The CD30 antigen also has been identified in many solid tumors, predominantly of germ cell origins and early clinical data is promising. OBJECTIVE Perform a focus literature review evaluating the prevalence of the CD30 antigen among nonlymphomatous tumors with a potential correlate for CD30 targeted therapy. ELIGIBILITY CRITERIA Inclusion criteria: all retrospective reviews and case reports citing CD30 positivity or negativity in non-lymphomatous malignancies in which data were presented based on location. EXCLUSION CRITERIA studies with hematopoetic malignancies, cutaneous malignancies, non-human populations, and non-english publications. INCLUDED STUDIES A total of 119 articles met these criteria and are summarized in this manuscript. CONCLUSION The CD30 antigen has shown variable prevalence among non-hematopoetic tumors, most notably among germ cell tumors and mesothelioma. With additional, preclinical and properly powered clinical studies, CD30 targeted therapy such as that of BV, alone or in combination with other agents may prove to be a strong candidate in the treatment of various CD30+ malignancies.
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Affiliation(s)
- Garrett K Berger
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States; Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States.
| | - Kevin Gee
- College of Medicine, University of Arizona, Tucson, AZ, 85721, United States
| | - Cassandra Votruba
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States
| | - Ali McBride
- College of Pharmacy, University of Arizona, Tucson, AZ, 85721, United States; Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States
| | - Faiz Anwer
- Hematology, Oncology, Blood & Marrow Transplantation, Department of Medicine, University of Arizona, Tucson, AZ, 85721, United States
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Intraoral Myeloid sarcoma with bilateral involvement: Case report. BALKAN JOURNAL OF DENTAL MEDICINE 2017. [DOI: 10.1515/bjdm-2017-0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Myeloid sarcoma (MS) is a solid malignant tumour associated with infiltration of immature myeloid precursor cells in an extramedullary site. The term MS has replaced the term granulocytic sarcoma and chloroma, which were used in the past. MS in the oral cavity is very uncommon, with less of 40 cases reported until recently. Case Report: We report the first case, the features, and the diagnostic sequence, of intraoral MS with bilateral palatal involvement, which presented as an initial manifestation, and preceded the appearance of acute myeloid leukemia (AML). Diagnostic confirmation of such oral mucosal lesions usually requires biopsy, histopathological examination with additional immunohistochemical investigation. MS can occur during the course of acute or chronic myelogenous leukemia, and myelodysplastic syndromes. In the vast majority of the reported cases, only one site was involved with a single intraoral MS lesion, and the cases predominantly associated with AML. Conclusion: The majority of intraoral MS occurs in patients with known AML, but in some of them, presented as an initial manifestation, and preceded the appearance of the disease. Therefore, clinicians should carefully evaluate all unusual oral lesions of unknown origin.
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11
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A Case Report on the Progression of Myeloid Sarcoma to Form Multiple Metastatic Deposits without Developing Acute Myeloid Leukaemia. Case Rep Hematol 2015; 2015:162154. [PMID: 26491577 PMCID: PMC4605259 DOI: 10.1155/2015/162154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/19/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Myeloid sarcomas (MS) are rare tumours occurring at extramedullary sites. They are usually associated with other haematology disorders such as acute myeloid leukaemia, myelodysplastic syndrome, and chronic myeloproliferative neoplasms. They frequently occur with a diagnosis of acute myeloid leukaemia (AML) or with relapse of preexisting disease. Patients with myeloid sarcomas without history or evidence of myeloid leukaemia typically progress to form AML. Case Presentation A case report of a patient diagnosed with an isolated myeloid sarcoma that rarely did not transform to AML but instead spread to form multiple myeloid sarcomas throughout the body. Discussion This case identifies the risk of metastatic spread of these tumours rather than the development of AML which is poorly documented in the literature, due to the rarity of cases, and may be significant in the investigation and management of isolated myeloid sarcomas. This case highlights the need for clinicians to consider repeat cross-sectional imaging to investigate unexplained clinical decline or symptoms, when there is no sign of AML progression and to consider radiotherapy treatment early.
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Shen J, Du X, Diao X, Zhao L, Wang W, Yu Y, Luo H. Myeloid Sarcoma Presenting With Multiple Skin and Subcutaneous Mass Without Leukemic Manifestations After Renal Transplantation. Transplant Proc 2015; 47:2227-32. [PMID: 26361685 DOI: 10.1016/j.transproceed.2015.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 06/02/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND Myeloid sarcoma is well described and known in clinical practice, however, it is a rare condition after receiving renal transplantation. Immunosuppressive therapy is thought to be the main cause in these cases. CASE REPORT A 45-year-old woman accepted a right kidney transplantation because of her chronic renal insufficiency and uremia in May 2011. She had to receive a left kidney transplantation again in February 2012 because she had renal failure again after receiving the right kidney transplantation. She received immune inhibitors treatment. After the latter operation, her renal function was normal. The third operation was done to remove the right transplanted kidney in July 2012. The diagnosis of the kidney was myeloid sarcoma. The blood and bone marrow biopsy had no evidence of leukemia. She then received chemotherapy. There was a small skin nodule on the left arm of approximately 0.5 cm in August 2012; after that its diameter enlarged progressively to about 5 cm and more nodules and masses gradually appeared on her face, arms, trunk, lower limbs, and feet over the course of 1 year. The skin biopsy specimen obtained from her left arm showed myeloid sarcoma too. She was admitted to the Orthopedics Department for severe pain and swelling in the left foot in September 2014 and underwent an operation for resecting the mass in the left foot. Pain was apparently alleviated and the incision healed well. CONCLUSIONS The patient is still alive with no evidence of leukemia after a 30-month follow-up.
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Affiliation(s)
- J Shen
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - X Du
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
| | - X Diao
- Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - L Zhao
- Department of Medical Information Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - W Wang
- Department of Urology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Y Yu
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - H Luo
- Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
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Benveniste H, Hof PR, Nedergaard M, Bechter K. Modern cerebrospinal fluid flow research and Heinrich Quincke's seminal 1872 article on the distribution of cinnabar in freely moving animals. J Comp Neurol 2015; 523:1748-55. [PMID: 25684428 DOI: 10.1002/cne.23758] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/06/2015] [Accepted: 02/09/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Helene Benveniste
- Departments of Anesthesiology and Radiology, University of Stony Brook, School of Medicine, Stony Brook, New York, 11794, USA
| | - Patrick R Hof
- Fishberg Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, 10029, USA
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Rochester Medical Center, School of Medicine, Rochester, New York, 14642, USA
| | - Karl Bechter
- Department of Psychosomatics/Psychotherapy, Ulm University, D-89312, Günzburg, Germany
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Brazelton J, Louis P, Sullivan J, Peker D. Temporomandibular joint arthritis as an initial presentation of acute myeloid leukemia with myelodysplasia-related changes: a report of an unusual case. J Oral Maxillofac Surg 2014; 72:1677-83. [PMID: 24661537 DOI: 10.1016/j.joms.2014.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Revised: 01/27/2014] [Accepted: 02/01/2014] [Indexed: 12/11/2022]
Abstract
PURPOSE Patients with acute myeloid leukemia (AML) often present with fatigue and severe pancytopenia. We report the case of a 68-year-old woman with no significant medical history who presented with 1 year of progressively worsening bilateral temporomandibular joint (TMJ) pain. She was otherwise asymptomatic. A computed tomography scan revealed degenerative joint disease in both TMJs. Bilateral TMJ replacement was performed. MATERIALS AND METHODS The excised TMJ tissue underwent formalin fixation and decalcification, and routine hematoxylin and eosin-stained sections were generated. RESULTS Immunohistochemical stains showed a population of monotonous cells in the marrow space expressing CD33, CD43, and myeloperoxidase, confirming the diagnosis of myeloid neoplasm. Subsequent bone marrow biopsy with flow cytometry confirmed AML with myelodysplasia-related changes. CONCLUSIONS Adult patients with AML can rarely present with musculoskeletal complaints alone, which could delay the diagnosis. To our knowledge, this is the first report of AML with myelodysplasia-related changes presenting in a patient with TMJ degenerative joint disease that was otherwise asymptomatic.
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Affiliation(s)
- Jason Brazelton
- Resident, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Patrick Louis
- Professor, Department of Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, AL
| | - Joseph Sullivan
- Associate Professor, Department of Radiology, University of Alabama at Birmingham, Birmingham, AL
| | - Deniz Peker
- Assistant Professor, Department of Pathology, University of Alabama at Birmingham, Birmingham, AL.
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Niscola P, Tendas A, Scaramucci L, Giovannini M, Cupelli L, Fratoni S, Perrotti A, de Fabritiis P. Gingival myeloid sarcoma in myelodysplastic syndrome. Support Care Cancer 2013; 21:917-8. [DOI: 10.1007/s00520-012-1702-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2012] [Accepted: 12/20/2012] [Indexed: 11/29/2022]
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Naidu A, Lerman MA. Clinical pathologic conference case 3: nodular fasciitis. Head Neck Pathol 2011; 5:276-80. [PMID: 21861079 PMCID: PMC3173537 DOI: 10.1007/s12105-011-0289-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 08/10/2011] [Indexed: 11/29/2022]
Abstract
Intraoral nodular nodular fasciitis is a rare entity that is important to recognize because it may simulate a malignancy clinically and histologically. The rapid growth and high mitotic index seen in nodular fasciitis may suggest a malignant neoplastic process, but it is generally considered to be a benign reactive proliferation. Recognizing the unique histologic features of nodular fasciitis is important to avoid a possible misdiagnosis as a malignancy, leading to unnecessary further treatment.
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Affiliation(s)
- Aparna Naidu
- Texas A&M Health Science Center-Baylor College of Dentistry, 3302 Gaston Ave., Dallas, TX 75246 USA
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Pau M, Beham-Schmid C, Zemann W, Kahr H, Kärcher H. Intraoral Granulocytic Sarcoma: A Case Report and Review of the Literature. J Oral Maxillofac Surg 2010; 68:2569-74. [DOI: 10.1016/j.joms.2009.09.040] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2009] [Revised: 06/29/2009] [Accepted: 09/15/2009] [Indexed: 01/06/2023]
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Different outcome of myeloid sarcoma with spinal cord compression preceding acute myeloid leukemia: Report of two cases and review of literatures. Chin J Cancer Res 2010. [DOI: 10.1007/s11670-010-0156-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Acute myeloid leukaemia diagnosed by intra-oral myeloid sarcoma. A case report. Head Neck Pathol 2010; 4:132-5. [PMID: 20512638 PMCID: PMC2878628 DOI: 10.1007/s12105-010-0163-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2009] [Accepted: 01/04/2010] [Indexed: 12/19/2022]
Abstract
Myeloid sarcoma (MS) is a rare extramedullary malignant tumor composed of immature myeloid cells. It is strongly associated with a well known or covert acute myeloid leukaemia, chronic myeloproliferative diseases or myelodysplastic syndromes. Intraoral MS scarcely occurs. An unusual case of acute myeloid leukaemia, which was diagnosed by mandibular MS that was developed in the alveolar socket after a dental extraction, is reported. The histological examination (including immunohistochemical analysis) of a subsequent biopsy showed infiltration of the oral mucosa by neoplastic cells. This lesion was therefore classified as acute myeloid leukaemia. The patient was referred to oncologists that confirmed the initial diagnosis. The patient underwent chemotherapy and the mandibular tumor disappeared. Forty days later, a relapse of the disease, which appeared as a great-ulcerated lesion, was developed in the hard palate. Thirty days after the second chemotherapy had finished, a new intraoral tumor was developed in the vestibular maxillary gingiva. Review of the literature shows no report of intraoral relapse and particularly multiple relapse of a MS that involves the oral cavity. Even though MS is encountered infrequently in the oral cavity, it should be considered in the differential diagnosis of conditions (especially tumors) with a similar clinical appearance.
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Mediastinal mass and malignant pleural effusion in an aleukemic case with pre-B acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2009; 31:139-41. [PMID: 19194202 DOI: 10.1097/mph.0b013e31818c2619] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pleural effusions and mediastinal masses are associated with certain types of hematologic malignancies. We report a 20-year-old man with a pleural effusion, a mediastinal mass, and a normal hemogram. The cytology of the pleural effusion initially suggested a lymphoma. However, an immunophenotypic study of the effusion revealed the following: TdT+, CD34+, CD19+, CD7(-), CD33(-), CD10(-), sIgM(-), and positive cytoplasmic mu heavy-chain immunoglobulins. After a bone marrow examination, we diagnosed the patient with pre-B acute lymphoblastic leukemia (ALL). This is the first reported case of a malignant pleural effusion and a mediastinal mass that preceded pre-B ALL. After standard therapy for ALL, the patient has been disease-free for 7 years.
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Lakhtakia R, Nema SK. Immunophenotyping of Tumours. Med J Armed Forces India 2008; 64:16-20. [PMID: 27408072 DOI: 10.1016/s0377-1237(08)80138-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Accepted: 03/24/2006] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Immunophenotyping has added a new dimension to improve the diagnostic accuracy of malignant diseases. The emphasis is on its usefulness in planning and institution of specific therapy besides helping in prognostication. METHODS The study included 83/1385 biopsies of cancer patients over an 18 month period on which immunohistochemical staining (IHC) with monoclonal antibodies were performed. The technique was used to establish the histogenetic origins/expression of the tumours. The study excluded haematolymphoid malignancies. RESULT Eighty three cases on whom IHC was performed included poorly differentiated tumours (15), metastatic tumours (16), soft tissue tumours (35), central nervous system tumours (9) and miscellaneous (6). Two cases could not be typed. The clinicopathological correlation in terms of the management and the problems related to its misinterpretation are discussed. CONCLUSION Immunophenotyping of tumours in an oncology set up is significant in the 'Final Diagnosis'.
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Alexiev BA, Wang W, Ning Y, Chumsri S, Gojo I, Rodgers WH, Stass SA, Zhao XF. Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study. Diagn Pathol 2007; 2:42. [PMID: 17974004 PMCID: PMC2186303 DOI: 10.1186/1746-1596-2-42] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Accepted: 10/31/2007] [Indexed: 12/13/2022] Open
Abstract
Context. - Myeloid sarcoma (MS) is a neoplasm of immature granulocytes, monocytes, or both involving any extramedullary site. The correct diagnosis of MS is important for adequate therapy, which is often delayed because of a high misdiagnosis rate. Objective. - To evaluate the lineage differentiation of neoplastic cells in MS by immunohistochemistry, and to correlate the results with clinicopathologic findings and cytogenetic studies. Design. - Histologic and immunohistochemical examinations were performed on formalin-fixed paraffin-embedded tissue samples from 13 cases of MS. They were classified according to the World Health Organization criteria. Chromosomal analysis data were available in 11 cases. Clinical, pathological, and cytogenetic findings were analyzed. Results. - The study included six male and seven female patients with an age range of 25 to 72 years (mean, 49.3 years) and a male to female ratio of 1:1.2. MS de novo occurred in 4/13 (31%) of cases examined. The most sensitive immunohistochemical markers were CD43 and lysozyme present in all cases with MS (13/13, 100%). All de novo MS showed a normal karyotype, monoblastic differentiation, and lack of CD34. The most common chromosomal abnormalities in MS associated with a hematopoietic disorder were trisomy 8 and inv(16) (2/11, 18%). Conclusion. - An immunohistochemical panel including CD43, lysozyme, myeloperoxidase (MPO), CD68 (or CD163), CD117, CD3 and CD20 can successfully identify the vast majority of MS variants in formalin-fixed paraffin-embedded tissue sections. The present report expands the spectrum of our knowledge showing that de novo MS has frequent monoblastic differentiation and frequently carries a normal karyotype.
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Affiliation(s)
- Borislav A Alexiev
- Department of Pathology, University of Maryland Medical Center, 22 S Greene Street, Baltimore, MD 21201, USA.
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Xie Z, Zhang F, Song E, Ge W, Zhu F, Hu J. Intraoral granulocytic sarcoma presenting as multiple maxillary and mandibular masses: a case report and literature review. ACTA ACUST UNITED AC 2007; 103:e44-8. [PMID: 17428693 DOI: 10.1016/j.tripleo.2006.12.028] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2006] [Revised: 11/12/2006] [Accepted: 12/21/2006] [Indexed: 10/23/2022]
Abstract
Granulocytic sarcoma (GS) is an unusual localized tumor composed of immature granulocytic precursor cells that occurs in extramedullary sites. However, GS involving the oral cavity is rare. We report a case of intraoral GS with an unusual clinical presentation, including a history of chronic myelogenous leukemia in remission, multiple maxillary and mandibular gingival masses mimicking acute inflammation that developed over a short period, complete remission after 1 week of treatment with imatinib mesylate (Gleevec), and no bone marrow or peripheral blood involvement over a 6-month follow-up period. To our knowledge, this is the first report of treatment of intraoral GS with Gleevec resulting in a complete remission.
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Affiliation(s)
- Zhijian Xie
- Department of Oral and Maxillofacial Surgery, Affiliated Stomatological Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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