Skip to main content
Erschienen in: Head and Neck Pathology 2/2014

01.06.2014 | Case Report

Myeloid Sarcoma of the Nasopharynx Mimicking an Aggressive Lymphoma

verfasst von: Jacques Raphael, Alexander Valent, Colette Hanna, Nathalie Auger, Odile Casiraghi, Vincent Ribrag, Stephane De Botton, Veronique Saada

Erschienen in: Head and Neck Pathology | Ausgabe 2/2014

Einloggen, um Zugang zu erhalten

Abstract

Background

Myeloid sarcoma (MS) is a rare extra-medullary tumour of the myeloid lineage, which can be a difficult diagnosis to make.

Case presentation

We report the case of a 73-year-old male with a right-sided nasopharyngeal mass revealed on CT scan and MRI.

Results

An initial cytological and histological examination suggested a high-grade lymphoma. Nevertheless, the final diagnosis was a MS with an unusual involvement of the nasopharynx that was treated with a conventional induction leukemia therapy. Eight months later, the patient had persistent thrombocytopenia and a bone marrow aspiration showed the dysplasia of a high grade myelodysplastic syndrome and cytogenetics detected t(3;21). The patient was treated with a 5-Azacitidine (Vidaza) protocol until overt progression and disease evolution.

Conclusion

In conclusion few cases of MS involving the nasopharynx have been reported. Its diagnosis is often difficult and should be considered especially when a high index of suspicion is present and the immunophenotype of the malignant haematological cells is not clearly in favour of a lymphoma.
Literatur
1.
Zurück zum Zitat Campidelli C, Agostinelli C, Stitson R, et al. Myeloid sarcoma: extramedullary manifestation of myeloid disorders. Am J Clin Pathol. 2009;132:426–37.PubMedCrossRef Campidelli C, Agostinelli C, Stitson R, et al. Myeloid sarcoma: extramedullary manifestation of myeloid disorders. Am J Clin Pathol. 2009;132:426–37.PubMedCrossRef
2.
Zurück zum Zitat Zhou J, Bell D, Medeiros LJ. Myeloid Sarcoma of the Head and Neck Region. Arch Pathol Lab Med. 2013 Mar 26. Zhou J, Bell D, Medeiros LJ. Myeloid Sarcoma of the Head and Neck Region. Arch Pathol Lab Med. 2013 Mar 26.
3.
Zurück zum Zitat Muss HB, Moloney WC. Chloroma and other myeloblastic tumors. Blood. 1973;42:721–8.PubMed Muss HB, Moloney WC. Chloroma and other myeloblastic tumors. Blood. 1973;42:721–8.PubMed
4.
Zurück zum Zitat Paydas S, Zorludemir S, Ergin M. Granulocytic sarcoma: 32 cases and review of the literature. Leuk Lymph. 2006;47:2527–41.CrossRef Paydas S, Zorludemir S, Ergin M. Granulocytic sarcoma: 32 cases and review of the literature. Leuk Lymph. 2006;47:2527–41.CrossRef
5.
Zurück zum Zitat Lee KH, Lee JH, Kim S, et al. High frequency of extramedullary relapse of acute leukaemia after allogeneic bone marrow transplantation. Bone Marrow Transplant. 2000;26:147–52.PubMedCrossRef Lee KH, Lee JH, Kim S, et al. High frequency of extramedullary relapse of acute leukaemia after allogeneic bone marrow transplantation. Bone Marrow Transplant. 2000;26:147–52.PubMedCrossRef
6.
Zurück zum Zitat Au WY, Kwong YL, Ho WK, et al. Primary granulocytic sarcoma of the nasopharynx. Am J Hematol. 2001;67:273–4.PubMedCrossRef Au WY, Kwong YL, Ho WK, et al. Primary granulocytic sarcoma of the nasopharynx. Am J Hematol. 2001;67:273–4.PubMedCrossRef
7.
Zurück zum Zitat Kwong YL, Chan AC, Liang RH. Natural killer cell lymphoma/leukemia: pathology and treatment. Hematol Oncol. 1997;15(2):71–9.PubMedCrossRef Kwong YL, Chan AC, Liang RH. Natural killer cell lymphoma/leukemia: pathology and treatment. Hematol Oncol. 1997;15(2):71–9.PubMedCrossRef
8.
Zurück zum Zitat Tsai MH, Pai HH, Yen PT et al. Unusual localization of Castleman’s disease: report of the first case in the nasopharynx. Ear Nose Throat J. 1997;76(10):731–5, 739. Tsai MH, Pai HH, Yen PT et al. Unusual localization of Castleman’s disease: report of the first case in the nasopharynx. Ear Nose Throat J. 1997;76(10):731–5, 739.
9.
Zurück zum Zitat Desai S, Deshpande R, Jambhekar N. Follicular dendritic cell tumor of the parapharyngeal region. Head Neck. 1999;21:164–7.PubMedCrossRef Desai S, Deshpande R, Jambhekar N. Follicular dendritic cell tumor of the parapharyngeal region. Head Neck. 1999;21:164–7.PubMedCrossRef
10.
Zurück zum Zitat Sugimoto Y, Nishii K, Sakakura M, et al. Acute myeloid leukemia with t(8;21)(q22;q22) manifesting as granulocytic sarcomas in the rhinopharynx and external acoustic meatus at relapse after high-dose cytarabine: case report and review of the literature. Hematol J. 2004;5(1):84–9.PubMedCrossRef Sugimoto Y, Nishii K, Sakakura M, et al. Acute myeloid leukemia with t(8;21)(q22;q22) manifesting as granulocytic sarcomas in the rhinopharynx and external acoustic meatus at relapse after high-dose cytarabine: case report and review of the literature. Hematol J. 2004;5(1):84–9.PubMedCrossRef
11.
Zurück zum Zitat Menasce LP, Banerjee SS, Beckett E, et al. Extra-medullary myeloid tumor (granulocytic sarcoma) is often misdiagnosed: a study of 26 cases. Histopathology. 1999;34:391–8.PubMedCrossRef Menasce LP, Banerjee SS, Beckett E, et al. Extra-medullary myeloid tumor (granulocytic sarcoma) is often misdiagnosed: a study of 26 cases. Histopathology. 1999;34:391–8.PubMedCrossRef
12.
Zurück zum Zitat Roth MJ, Medeiros LJ, Elenitoba-Johnson K, et al. Extramedullary myeloid cell tumors. Arch Pathol Lab Med. 1995;119:790–7.PubMed Roth MJ, Medeiros LJ, Elenitoba-Johnson K, et al. Extramedullary myeloid cell tumors. Arch Pathol Lab Med. 1995;119:790–7.PubMed
13.
14.
Zurück zum Zitat Pileri SA, Ascani S, Cox MC, et al. Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia. 2007;21:340–50.PubMedCrossRef Pileri SA, Ascani S, Cox MC, et al. Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia. 2007;21:340–50.PubMedCrossRef
15.
Zurück zum Zitat Byrd JC, Edenfield WJ, Shields DJ, et al. Extramedullary myeloid cell tumors in acute nonlymphoblastic leukaemia: a clinical review. J Clin Oncol. 1995;13:1800–16.PubMed Byrd JC, Edenfield WJ, Shields DJ, et al. Extramedullary myeloid cell tumors in acute nonlymphoblastic leukaemia: a clinical review. J Clin Oncol. 1995;13:1800–16.PubMed
16.
Zurück zum Zitat Zhang XH, Zhang R, Li Y. Granulocytic sarcoma of abdomen in acute myeloid leukemia patient with inv(16) and t(6;17) abnormal chromosome: case report and review of literature. Leuk Res. 2010;34:958–61.PubMedCrossRef Zhang XH, Zhang R, Li Y. Granulocytic sarcoma of abdomen in acute myeloid leukemia patient with inv(16) and t(6;17) abnormal chromosome: case report and review of literature. Leuk Res. 2010;34:958–61.PubMedCrossRef
17.
Zurück zum Zitat Tirado CA, Chen W, Valdez F, et al. Unusual presentation of myeloid sarcoma in a case of acute promyelocytic leukemia with a cryptic PML-RARA rearrangement involving multiple sites including the atrium. Cancer Genet Cytogenet. 2010;200:47–53.PubMedCrossRef Tirado CA, Chen W, Valdez F, et al. Unusual presentation of myeloid sarcoma in a case of acute promyelocytic leukemia with a cryptic PML-RARA rearrangement involving multiple sites including the atrium. Cancer Genet Cytogenet. 2010;200:47–53.PubMedCrossRef
18.
Zurück zum Zitat Worch J, Ritter J, Fruhwald MC. Presentation of acute promyelocytic leukemia as granulocytic sarcoma. Pediatr Blood Cancer. 2008;50:657–60.PubMedCrossRef Worch J, Ritter J, Fruhwald MC. Presentation of acute promyelocytic leukemia as granulocytic sarcoma. Pediatr Blood Cancer. 2008;50:657–60.PubMedCrossRef
19.
Zurück zum Zitat Kayser S, Döhner K, Krauter J, et al. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood. 2011;117:2137–45.PubMedCrossRef Kayser S, Döhner K, Krauter J, et al. The impact of therapy-related acute myeloid leukemia (AML) on outcome in 2853 adult patients with newly diagnosed AML. Blood. 2011;117:2137–45.PubMedCrossRef
20.
Zurück zum Zitat Tsimberidou AM, Kantarjian HM, Wen S, et al. Myeloid sarcoma is associated with superior event-free survival and overall survival compared with acute myeloid leukemia. Cancer. 2008;113(6):1370–8.PubMedCentralPubMedCrossRef Tsimberidou AM, Kantarjian HM, Wen S, et al. Myeloid sarcoma is associated with superior event-free survival and overall survival compared with acute myeloid leukemia. Cancer. 2008;113(6):1370–8.PubMedCentralPubMedCrossRef
21.
Zurück zum Zitat Chak LY, Sapozink MD, Cox RS. Extramedullary lesions in non-lymphocytic leukemia: results of radiation therapy. Int J Radiat Oncol Biol Phys. 1983;9:1173–6.PubMedCrossRef Chak LY, Sapozink MD, Cox RS. Extramedullary lesions in non-lymphocytic leukemia: results of radiation therapy. Int J Radiat Oncol Biol Phys. 1983;9:1173–6.PubMedCrossRef
22.
Zurück zum Zitat Bakst R, Wolden S, Yahalom J. Radiation therapy for chloroma (granulocytic sarcoma). Int J Radiat Oncol Biol Phys. 2012;82(5):1816–22.PubMedCrossRef Bakst R, Wolden S, Yahalom J. Radiation therapy for chloroma (granulocytic sarcoma). Int J Radiat Oncol Biol Phys. 2012;82(5):1816–22.PubMedCrossRef
Metadaten
Titel
Myeloid Sarcoma of the Nasopharynx Mimicking an Aggressive Lymphoma
verfasst von
Jacques Raphael
Alexander Valent
Colette Hanna
Nathalie Auger
Odile Casiraghi
Vincent Ribrag
Stephane De Botton
Veronique Saada
Publikationsdatum
01.06.2014
Verlag
Springer US
Erschienen in
Head and Neck Pathology / Ausgabe 2/2014
Elektronische ISSN: 1936-0568
DOI
https://doi.org/10.1007/s12105-013-0495-3

Weitere Artikel der Ausgabe 2/2014

Head and Neck Pathology 2/2014 Zur Ausgabe

Neu im Fachgebiet Pathologie

Molekularpathologische Untersuchungen im Wandel der Zeit

Open Access Biomarker Leitthema

Um auch an kleinen Gewebeproben zuverlässige und reproduzierbare Ergebnisse zu gewährleisten ist eine strenge Qualitätskontrolle in jedem Schritt des Arbeitsablaufs erforderlich. Eine nicht ordnungsgemäße Prüfung oder Behandlung des …

Vergleichende Pathologie in der onkologischen Forschung

Pathologie Leitthema

Die vergleichende experimentelle Pathologie („comparative experimental pathology“) ist ein Fachbereich an der Schnittstelle von Human- und Veterinärmedizin. Sie widmet sich der vergleichenden Erforschung von Gemeinsamkeiten und Unterschieden von …

Gastrointestinale Stromatumoren

Open Access GIST CME-Artikel

Gastrointestinale Stromatumoren (GIST) stellen seit über 20 Jahren ein Paradigma für die zielgerichtete Therapie mit Tyrosinkinaseinhibitoren dar. Eine elementare Voraussetzung für eine mögliche neoadjuvante oder adjuvante Behandlung bei …

Personalisierte Medizin in der Onkologie

Aufgrund des erheblichen technologischen Fortschritts in der molekularen und genetischen Diagnostik sowie zunehmender Erkenntnisse über die molekulare Pathogenese von Krankheiten hat in den letzten zwei Jahrzehnten ein grundlegender …