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急性髓系白血病中以肉眼血尿为表现的膀胱髓系肉瘤

Macroscopic Hematuria Revealing Bladder Myeloid Sarcoma in Acute Myeloid Leukemia.

作者信息

Halloumi Omar, Sebastian Wittnebel, Harb Mirvate, Trépant Anne Laure, Andreozzi Fabio

机构信息

Department of Clinical Hematology and Cellular Therapy, Centre Hospitalier Universitaire (CHU) Souss-Massa, Agadir, MAR.

Faculty of Medicine and Pharmacy, Université Ibn Zohr, Agadir, MAR.

出版信息

Cureus. 2024 Dec 17;16(12):e75912. doi: 10.7759/cureus.75912. eCollection 2024 Dec.

DOI:10.7759/cureus.75912
PMID:39830569
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11739638/
Abstract

Acute myeloid leukemia (AML) can be presented with extramedullary manifestations, more frequently involving skin and rarely other sites, such as the urinary tract. We report the case of a 37-year-old male patient with a history of testicular cancer who presented to the emergency department with cytopenias and hematuria. Bone marrow analysis diagnosed AML (French-American-British(FAB) classificationM4 subtype, karyotype showing inv16). A diagnostic workup for hematuria revealed a bladder mass that underwent biopsy. Histopathology revealed myeloid sarcoma. The patient was treated with standard induction chemotherapy, followed by consolidation therapy including allogeneic stem cell transplantation, which resulted in complete remission of AML.

摘要

急性髓系白血病(AML)可出现髓外表现,更常见累及皮肤,很少累及其他部位,如泌尿道。我们报告一例37岁男性患者,有睾丸癌病史,因血细胞减少和血尿就诊于急诊科。骨髓分析诊断为AML(法国-美国-英国(FAB)分类M4亚型,核型显示inv16)。对血尿进行的诊断性检查发现膀胱肿物并进行了活检。组织病理学显示为髓系肉瘤。该患者接受了标准诱导化疗,随后进行了包括异基因干细胞移植在内的巩固治疗,结果AML完全缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/5a2e8f5579b0/cureus-0016-00000075912-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/74cf5146f8ab/cureus-0016-00000075912-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/1e76ef57a323/cureus-0016-00000075912-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/5a2e8f5579b0/cureus-0016-00000075912-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/74cf5146f8ab/cureus-0016-00000075912-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/1e76ef57a323/cureus-0016-00000075912-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd6/11739638/5a2e8f5579b0/cureus-0016-00000075912-i03.jpg

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本文引用的文献

1
Isolated myeloid sarcoma in the urinary bladder: A cases report.膀胱孤立性髓系肉瘤:一例病例报告。
Asian J Surg. 2024 Apr;47(4):1928-1929. doi: 10.1016/j.asjsur.2023.12.074. Epub 2024 Jan 11.
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Myeloid sarcoma of the urinary bladder as the presenting feature of secondary acute myeloid leukemia, successfully treated with venetoclax and azacitidine.膀胱髓系肉瘤作为继发性急性髓系白血病的首发表现,经维奈克拉和阿扎胞苷成功治疗。
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儿童膀胱粒细胞肉瘤:病例报告及文献综述
Turk J Pediatr. 2022;64(1):152-159. doi: 10.24953/turkjped.2020.275.
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Bladder Myeloid Sarcoma with mutated Myelodysplastic Syndrome/Myeloproliferative Neoplasm Overlap syndrome: Response to Decitabine-Venetoclax regimen.伴有骨髓增生异常综合征/骨髓增殖性肿瘤重叠综合征突变的膀胱髓系肉瘤:对地西他滨-维奈克拉方案的反应
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Case Rep Oncol. 2021 Sep 21;14(3):1366-1372. doi: 10.1159/000518529. eCollection 2021 Sep-Dec.
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Leuk Res. 2017 Feb;53:74-81. doi: 10.1016/j.leukres.2016.12.003. Epub 2016 Dec 20.
7
Diagnosis and management of AML in adults: 2017 ELN recommendations from an international expert panel.成人急性髓系白血病的诊断与管理:2017年国际专家小组的欧洲白血病网络(ELN)建议
Blood. 2017 Jan 26;129(4):424-447. doi: 10.1182/blood-2016-08-733196. Epub 2016 Nov 28.
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Myeloid Sarcoma of the Bladder in the Setting of Refractory Anemia with Excess Blasts-2 (RAEB-2).
W V Med J. 2015 Nov-Dec;111(6):34-6.
9
Granulocytic sarcoma of bladder in an 18-mo-old child with acute myeloid leukemia.一名18个月大的急性髓性白血病患儿发生膀胱粒细胞肉瘤。
Indian J Pediatr. 2014 Oct;81(10):1118-9. doi: 10.1007/s12098-014-1371-1. Epub 2014 Feb 25.
10
Unusual presentation of bladder myeloid sarcoma causing acute renal failure: case report and review of the literature.膀胱髓系肉瘤导致急性肾衰竭的罕见表现:病例报告及文献复习
Clin Adv Hematol Oncol. 2013 Jun;11(6):388-93.