Pullarkat Vinod, Veliz Leslie, Chang Karen, Mohrbacher Ann, Teotico Anna Lizza, Forman Stephen J, Slovak Marilyn L
Division of Haematology, City of Hope National Medical Center, Duarte, California 91010, USA.
J Clin Pathol. 2007 May;60(5):562-4. doi: 10.1136/jcp.2005.033266.
Myeloid sarcomas are tumour masses of myeloid leukaemic cells at extramedullary sites. These tumours can, on occasion, occur without concurrent or antecedent leukaemia. Myeloid sarcomas have been described at unusual locations including the female genital tract. An unusual case of therapy-related acute myeloid leukaemia (t-AML) presenting as isolated monoblastic myeloid sarcoma of the uterus in a patient who had received adjuvant chemotherapy for breast cancer is presented. Fluorescence in situ hybridisation analysis performed on paraffin-wax-embedded tumour tissue revealed a mixed-lineage leukaemia (MLL) gene rearrangement, supporting the association of this malignancy with prior chemotherapy. This case illustrates that t-AML can rarely present as isolated extramedullary tumours, and the detection of specific chromosomal abnormalities in these myeloid sarcomas can be useful for risk assessment and guiding definitive therapy.
髓系肉瘤是髓系白血病细胞在髓外部位形成的肿瘤块。这些肿瘤有时可在无并发或既往白血病的情况下发生。髓系肉瘤已在包括女性生殖道在内的不寻常部位被描述。本文报告了一例与治疗相关的急性髓系白血病(t-AML),该患者曾接受乳腺癌辅助化疗,表现为孤立的子宫单核细胞髓系肉瘤。对石蜡包埋的肿瘤组织进行荧光原位杂交分析,发现了混合谱系白血病(MLL)基因重排,支持这种恶性肿瘤与既往化疗的关联。该病例表明,t-AML很少表现为孤立的髓外肿瘤,在这些髓系肉瘤中检测特定的染色体异常有助于风险评估和指导确定性治疗。