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[一例前纵隔髓系肉瘤]

[A case of myeloid sarcoma in the anterior mediastinum].

作者信息

Yamamoto Hidenori, Sanda Ryo, Ota Akiko, Kato Motoaki, Takagi Yasuyuki, Sugino Yasuteru

机构信息

Department of Integrated Medicine, Toyota Memorial Hospital.

出版信息

Nihon Kokyuki Gakkai Zasshi. 2011 Jan;49(1):25-9.

Abstract

We report a case of myeloid sarcoma in the anterior mediastinum. The patient was a 33-year-old man with a chief complaint of right shoulder pain, right upper limb edema, and cough. Chest contrast-enhanced computed tomography (CT) revealed a partially enhanced anterior mediastinal tumor. A CT-guided biopsy was then performed, and a Hematoxylin-eosin (HE) stain revealed mitosis of tumor cells and other cells, including eosinophils. Immunohistochemical stains with myeloperoxidase, CD34, CD43, CD68 and c-Kit tests were positive for tumor cells. Due to a pathological diagnosis of myeloid sarcoma, he was treated with chemotherapy based on a diagnosis of acute myelogenous leukemia. After complete remission was obtained, the patient visited another hospital to receive an unrelated bone marrow transplantation. Although it rarely occurs as a mediastinal tumor, the prognosis of myeloid sarcoma is unfavorable, and thus should be taken into consideration as a differential diagnosis.

摘要

我们报告一例前纵隔髓系肉瘤病例。患者为一名33岁男性,主要症状为右肩疼痛、右上肢水肿和咳嗽。胸部增强计算机断层扫描(CT)显示前纵隔肿瘤部分强化。随后进行了CT引导下活检,苏木精-伊红(HE)染色显示肿瘤细胞及其他细胞(包括嗜酸性粒细胞)有丝分裂。肿瘤细胞髓过氧化物酶、CD34、CD43、CD68和c-Kit免疫组化染色均呈阳性。由于病理诊断为髓系肉瘤,他根据急性髓系白血病的诊断接受了化疗。获得完全缓解后,患者前往另一家医院接受非亲缘骨髓移植。尽管髓系肉瘤很少作为纵隔肿瘤出现,但其预后不佳,因此应作为鉴别诊断予以考虑。

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