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Erschienen in: Indian Journal of Hematology and Blood Transfusion 1/2016

09.02.2016 | Images

Shoulder Myeloid Sarcoma: An Initial Presentation of CML Blast Crisis

verfasst von: Ankur Jain, Kamal Kant Sahu, Saniya Sharma, Arvind Rajwanshi, Vikas Suri, Pankaj Malhotra

Erschienen in: Indian Journal of Hematology and Blood Transfusion | Sonderheft 1/2016

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Abstract

Myeloid sarcoma (MS) represents extra medullary accumulation of the immature cells of granulocytic series and occurs most commonly in the setting of acute myelogenous leukemia. Its occurrence in chronic myeloid leukemia (CML), myelodysplastic syndrome and other myeloproliferative neoplasm is uncommon. We here in report a 35-year old lady who was diagnosed as CML-chronic phase (CP) in the year 2004 and was on imatinib (400 mg OD) since then with regular follow up and good compliance. She had progression to accelerated phase in April 2014 which was managed by increasing the dose of imatinib to 600 mg OD. In August 2015, she presented with complaints of pain and swelling of the left shoulder suggestive of septic arthritis. Investigations revealed an ill-defined lesion involving muscles around the shoulder and clavicle. Absence of response to antibiotics and negative work up for infectious etiology raised the suspicion for MS which was later confirmed by immunohistochemistry of the aspirate from the lesion. Bone marrow examination was consistent with CML-CP. Hence, the diagnosis of CML with extra medullary blast crises was made. Patient was treated with a combination of high dose imatinib, hydroxyurea, cytarabine and local radiotherapy. Rarity of MS involving the shoulder and it’s resemblance to septic arthritis has been highlighted in the present case. We emphasize the importance of immunohistochemistry of the aspirate for the timely and correct diagnosis of the cases who do not respond to an initial antibiotic trial.
Literatur
2.
Zurück zum Zitat Sahu KK, Tyagi R, Law AD, Khadwal A, Prakash G, Rajwanshi A et al (2015) Myeloid sarcoma: an unusual case of mediastinal mass and malignant pleural effusion with review of literature. Indian J Hematol Blood Transfus 31(4):466–471CrossRefPubMed Sahu KK, Tyagi R, Law AD, Khadwal A, Prakash G, Rajwanshi A et al (2015) Myeloid sarcoma: an unusual case of mediastinal mass and malignant pleural effusion with review of literature. Indian J Hematol Blood Transfus 31(4):466–471CrossRefPubMed
3.
Zurück zum Zitat Upadhyay S, Rawat SJ, Gupta G, Saxena U (2014) Chloroma (Granulocytic sarcoma): an unusual cause of shoulder pain in chronic myeloid leukemia; a diagnostic dilemma. J Orthop Allied Sci 2:20–23CrossRef Upadhyay S, Rawat SJ, Gupta G, Saxena U (2014) Chloroma (Granulocytic sarcoma): an unusual cause of shoulder pain in chronic myeloid leukemia; a diagnostic dilemma. J Orthop Allied Sci 2:20–23CrossRef
4.
Zurück zum Zitat Tsimberidou AM, Kantarjian HM, Wen S, Keating MJ, O’Brien S, Brandt M et al (2008) Myeloid sarcoma is associated with superior event-free survival and overall survival compared with acute myeloid leukemia. Cancer 113(6):1370–1378CrossRefPubMedPubMedCentral Tsimberidou AM, Kantarjian HM, Wen S, Keating MJ, O’Brien S, Brandt M et al (2008) Myeloid sarcoma is associated with superior event-free survival and overall survival compared with acute myeloid leukemia. Cancer 113(6):1370–1378CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Tsimberidou AM, Kantarjian HM, Estey E, Cortes JE, Verstovsek S, Faderl S et al (2003) Outcome in patients with nonleukemic granulocytic sarcoma treated with chemotherapy with or without radiotherapy. Leukemia 17(6):1100–1103CrossRefPubMed Tsimberidou AM, Kantarjian HM, Estey E, Cortes JE, Verstovsek S, Faderl S et al (2003) Outcome in patients with nonleukemic granulocytic sarcoma treated with chemotherapy with or without radiotherapy. Leukemia 17(6):1100–1103CrossRefPubMed
Metadaten
Titel
Shoulder Myeloid Sarcoma: An Initial Presentation of CML Blast Crisis
verfasst von
Ankur Jain
Kamal Kant Sahu
Saniya Sharma
Arvind Rajwanshi
Vikas Suri
Pankaj Malhotra
Publikationsdatum
09.02.2016
Verlag
Springer India
Erschienen in
Indian Journal of Hematology and Blood Transfusion / Ausgabe Sonderheft 1/2016
Print ISSN: 0971-4502
Elektronische ISSN: 0974-0449
DOI
https://doi.org/10.1007/s12288-016-0656-0

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