Department of Pathology, Faculty of Medical Sciences, Queen Elizabeth Hospital, St. Michael, Barbados.
J Low Genit Tract Dis. 2010 Apr;14(2):136-41. doi: 10.1097/LGT.0b013e3181be2999.
To describe 2 cases of myeloid sarcoma of the vagina, in a patient without a history of acute myeloid leukemia (AML) and in another whose condition was previously diagnosed with AML.
The clinical histories of 2 patients whose conditions were diagnosed with myeloid sarcoma of the vagina were obtained from their medical records.
Case 1: A 77-year-old woman with no systemic illnesses presented with a vaginal lump. Clinically, there was a 6-cm periurethral mass that was examined by biopsy. The histopathologic specimen was evaluated on routine and immunohistochemical stains, and myeloid sarcoma was diagnosed after extensive immunohistochemical analysis. The patient was treated with pelvic radiation. She developed extensive myeloid sarcoma of the skin and AML 4.5 months later; she died 2 weeks later, 5 months after the initial presentation. Case 2: A 36-year-old woman with a known history of AML who has had multiple leukemic and extramedullary recurrences presented with a pelvic mass. Physical findings revealed large masses in the vagina and rectovaginal septum, which were confirmed as myeloid sarcoma after biopsy and histologic examination. The patient was treated with pelvic/vaginal radiation. Five months later, she had another leukemic relapse and died within 1 day of palliative chemotherapy.
Myeloid sarcoma of the vagina is extremely rare. Most patients have a poor prognosis and either have a history of or will subsequently develop AML.
描述 2 例阴道髓系肉瘤病例,其中 1 例患者无急性髓系白血病(AML)病史,另 1 例患者此前被诊断为 AML。
从病历中获取了 2 例被诊断为阴道髓系肉瘤的患者的临床病史。
病例 1:1 名 77 岁女性,无系统性疾病,出现阴道肿块。临床检查可见尿道周围有一个 6cm 的肿块,通过活检进行检查。对常规和免疫组织化学染色的组织病理标本进行评估后,经过广泛的免疫组织化学分析,诊断为髓系肉瘤。患者接受了骨盆放疗。4.5 个月后,她出现广泛的皮肤髓系肉瘤和 AML,2 周后死亡,即初次就诊后 5 个月。病例 2:1 名 36 岁女性,患有已知的 AML,且多次发生白血病和骨髓外复发,出现骨盆肿块。体格检查发现阴道和直肠阴道隔有大肿块,活检和组织学检查后证实为髓系肉瘤。患者接受了骨盆/阴道放疗。5 个月后,她再次出现白血病复发,并在姑息性化疗后 1 天内死亡。
阴道髓系肉瘤非常罕见。大多数患者预后不良,要么有 AML 病史,要么随后会发展为 AML。