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并发Sweet综合征和急性髓系白血病中的克隆性中性粒细胞浸润:一例报告及文献复习

Clonal neutrophil infiltrates in concurrent Sweet's syndrome and acute myeloid leukemia: A case report and literature review.

作者信息

Mo Wenbin, Wang Xiaoxue, Wang Yue, Li Yan, Zhang Rui

机构信息

Department of Hematology, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Shenyang, Liaoning 110001, PR China.

Department of Hematology, The First Affiliated Hospital of China Medical University, No.155, Nanjing North Street, Shenyang, Liaoning 110001, PR China.

出版信息

Cancer Genet. 2018 Oct;226-227:11-16. doi: 10.1016/j.cancergen.2018.04.120. Epub 2018 May 10.

Abstract

Sweet's syndrome (SS), also known as acute febrile neutrophilic dermatosis is often associated with a hematological malignancy, especially acute myeloid leukemia (AML) and myeloid dysplasia syndrome. Histopathologically, SS is characterized by diffuse infiltrates in the upper dermis, predominantly consisting of mature neutrophils. The origin of neutrophils invading the skin remains unknown. Herein, we report a patient with concurrent acute monoblastic leukemia and SS who initially presented with discrete erythematous papules and nodules on the neck. Single nucleotide polymorphism (SNP) array and next generation sequencing (NGS) revealed a concordant fms-related tyrosine kinase-3 (FLT-3) gene mutation in the bone marrow and skin lesion, indicating that the neutrophilic infiltrates were clonally related to the underlying myeloid neoplasm. This is the first case report of concurrent SS and AML, in which SNP array and NGS analysis were applied to confirm the clonality of the neutrophilic infiltrates.

摘要

斯威特综合征(SS),又称急性发热性嗜中性皮病,常与血液系统恶性肿瘤相关,尤其是急性髓系白血病(AML)和骨髓发育异常综合征。组织病理学上,SS的特征是真皮上层弥漫性浸润,主要由成熟嗜中性粒细胞组成。侵入皮肤的嗜中性粒细胞的来源尚不清楚。在此,我们报告一例同时患有急性单核细胞白血病和SS的患者,该患者最初颈部出现散在的红斑丘疹和结节。单核苷酸多态性(SNP)阵列和下一代测序(NGS)显示骨髓和皮肤病变中存在一致的fms相关酪氨酸激酶-3(FLT-3)基因突变,表明嗜中性粒细胞浸润与潜在的髓系肿瘤存在克隆相关性。这是首例同时患有SS和AML的病例报告,其中应用SNP阵列和NGS分析来确认嗜中性粒细胞浸润的克隆性。

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