Ha Yumi, Sung Duk Hyun, Park Yoonhong, Kim Du Hwan
Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Ann Rehabil Med. 2013 Apr;37(2):280-5. doi: 10.5535/arm.2013.37.2.280. Epub 2013 Apr 30.
Myeloid sarcoma is a solid, extramedullary tumor comprising of immature myeloid cells. It may occur in any organ; however, the invasion of peripheral nervous system is rare. Herein, we report the case of myeloid sarcoma on the brachial plexus. A 37-year-old woman with acute myelogenous leukemia achieved complete remission after chemotherapy. One year later, she presented right shoulder pain, progressive weakness in the right upper extremity and hypesthesia. Based on magnetic resonance images (MRI) and electrophysiologic study, a provisional diagnosis of brachial plexus neuritis was done and hence steroid pulse therapy was carried out. Three months later the patient presented epigastric pain. After upper gastrointestinal endoscopy, myeloid sarcoma of gastrointestinal tract was confirmed pathologically. Moreover, 18-fluoride fluorodeoxyglucose positron emission tomography showed a fusiform shaped mass lesion at the brachial plexus overlapping with previous high signal lesion on the MRI. Therefore, we concluded the final diagnosis as brachial plexopathy due to myeloid sarcoma.
髓系肉瘤是一种由未成熟髓样细胞组成的实体性髓外肿瘤。它可发生于任何器官；然而，侵犯周围神经系统的情况罕见。在此，我们报告一例臂丛神经髓系肉瘤病例。一名37岁急性髓系白血病女性患者化疗后达到完全缓解。一年后，她出现右肩疼痛、右上肢进行性无力和感觉减退。基于磁共振成像（MRI）和电生理研究，初步诊断为臂丛神经炎，因此进行了类固醇冲击治疗。三个月后患者出现上腹部疼痛。上消化道内镜检查后，经病理证实为胃肠道髓系肉瘤。此外，18氟脱氧葡萄糖正电子发射断层显像显示臂丛神经处有一梭形肿块病变，与之前MRI上的高信号病变重叠。因此，我们最终诊断为髓系肉瘤所致臂丛神经病变。
