Department of Pediatric Oncology, Pediatric Hospital, Cairo, Egypt.
Department of Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA.
Oncol Res Treat. 2019;42(4):224-229. doi: 10.1159/000497210. Epub 2019 Mar 6.
Hematological malignancies can manifest as extramedullary soft tissue masses in relatively rare cases. The rarity of it causes a diagnostic and therapeutic challenge. One of the rarest manifestations is myeloid sarcoma (MS). MS develops as part of acute myeloid leukemia, myeloproliferative neoplasm, or myelodysplastic syndrome or at relapse, especially following allogeneic hematopoietic stem cell transplant. The tumor displays high myeloperoxidase expression, hence the color green, and is called chloroma. It most commonly appears in lymph nodes, skin and soft tissues, bone, testes, gastrointestinal tract, and peritoneum. Immunohistochemistry shows CD68-KP1 as the most commonly expressed marker, then myeloperoxidase, CD117, CD99, CD68/PG-M1, lysozyme, CD34, terminal deoxynucleotidyl transferase, CD56, CD61, CD30, glycophorin A, and CD4. Different chromosomal abnormalities including MLL rearrangement, t(8; 21), monosomy 7, trisomy 8, trisomy 11, trisomy 4, inversion (16), monosomy 16,16q deletion, 5q deletion, and 20q deletion were reported. Most of the literature about MS are case reports and small retrospective studies, thus there is limited clinical knowledge of the cases and their presentation and management plans. Here, we provide a review of what has been reported in the literature about MS in the light of our experiences.
血液系统恶性肿瘤在极少数情况下可表现为骨髓外软组织肿块。由于其罕见性,给诊断和治疗带来了挑战。其中一种罕见的表现是髓样肉瘤(MS)。MS 是作为急性髓系白血病、骨髓增生性肿瘤或骨髓增生异常综合征的一部分发展而来,或者在复发时,尤其是在异基因造血干细胞移植后发生。肿瘤表现出高髓过氧化物酶表达,因此呈绿色,称为绿色瘤。它最常见于淋巴结、皮肤和软组织、骨骼、睾丸、胃肠道和腹膜。免疫组织化学显示 CD68-KP1 是最常表达的标志物,其次是髓过氧化物酶、CD117、CD99、CD68/PG-M1、溶菌酶、CD34、末端脱氧核苷酸转移酶、CD56、CD61、CD30、糖蛋白 A 和 CD4。已报道不同的染色体异常包括 MLL 重排、t(8;21)、单体 7、三体 8、三体 11、三体 4、倒位(16)、单体 16、16q 缺失、5q 缺失和 20q 缺失。大多数关于 MS 的文献都是病例报告和小型回顾性研究,因此对病例及其表现和管理计划的临床知识有限。在这里,我们根据我们的经验,对文献中报道的 MS 进行了综述。