Slavcheva V, Lukanov Tz, Tzvetkov N
Clinic of Hematology, University hospital, Pleven, Bulgaria.
J BUON. 2008 Oct-Dec;13(4):589-92.
Myeloid sarcoma is described as tumor mass consisting of myeloblasts or immature myeloid cells, involving extramedullary tissues. It can be initial manifestation of myeloproliferative disorders or relapse of previously treated acute myeloblastic leukemia (AML). We present two patients, one with AML-M2 and the other with acute promyelocytic leukemia (APL)-M3. After remission induced by conventional chemotherapy, which continued for 3 and 10 years respectively, a myeloid sarcoma was diagnosed. Biopsy of a retroauricular tumor formation was made in the first case. The second one was diagnozed after biopsy of a supraclavicular lymph node. In both cases complete laboratory investigation including blood smear, differential counting and flow cytometric analysis of bone marrow were normal. Despite this, the patients received chemotherapy. The APL-M3 patient was treated with radiotherapy to the involved supraclavicular lymph node which was followed by chemotherapy. Three months after radiotherapy bone marrow infiltration and blast cells in the peripheral blood were found. Two years after the diagnosis of myeloid sarcoma the patient died of haemorrhagic stroke. The patient with AML-M2 continued treatment with polychemotherapy.
髓系肉瘤被描述为由成髓细胞或未成熟髓系细胞组成的肿瘤块，累及髓外组织。它可以是骨髓增殖性疾病的初始表现，也可以是先前治疗的急性髓细胞白血病（AML）的复发。我们报告两名患者，一名患有AML-M2，另一名患有急性早幼粒细胞白血病（APL）-M3。在分别持续3年和10年的传统化疗诱导缓解后，诊断出髓系肉瘤。第一例对耳后肿瘤形成进行了活检。第二例在对锁骨上淋巴结进行活检后确诊。在这两例中，包括血液涂片、分类计数和骨髓流式细胞术分析在内的完整实验室检查均正常。尽管如此，患者仍接受了化疗。APL-M3患者接受了对受累锁骨上淋巴结的放射治疗，随后进行化疗。放疗三个月后发现骨髓浸润和外周血中的原始细胞。在诊断髓系肉瘤两年后，患者死于出血性中风。AML-M2患者继续接受多药化疗。
