Van Dijken P J, Niazi M, al-Asiri R H
Department of Pediatric Oncology/Hematology, University Children's Hospital for Children, Utrecht, The Netherlands.
Cancer Genet Cytogenet. 1994 Sep;76(2):151-3. doi: 10.1016/0165-4608(94)90468-5.
We report a case of Philadelphia chromosome positive (Ph+) chronic myelocytic leukemia (CML) in a 4-year-old child presenting with a one-sided cervical chloroma (granulocytic sarcoma) of 5 months duration preceded by an inflammatory reaction in the same area. Blood and bone marrow were consistent with CML in chronic phase. Cytogenetic analysis of blood, bone marrow and chloroma showed, in addition to the classical Ph+ cell line, another clone with additional aberrations: 50,XY,+Y,+8,t(9;22)(q34;q11), +19,+21, present predominantly in the chloroma. In conclusion, this is the first report of a Ph+ CML in a young child with a chloroma as an isolated extramedullary localization of blastic transformation. It is hypothesized that local events such as inflammation might be inductive of extramedullary blastic transformation.
我们报告了一例4岁儿童费城染色体阳性（Ph+）慢性粒细胞白血病（CML），该患儿单侧颈部出现持续5个月的绿色瘤（粒细胞肉瘤），在此之前同一区域有炎症反应。血液和骨髓检查结果与慢性期CML一致。对血液、骨髓和绿色瘤进行细胞遗传学分析显示，除了经典的Ph+细胞系外，另一个克隆存在其他异常：50,XY,+Y,+8,t(9;22)(q34;q11), +19,+21，主要存在于绿色瘤中。总之，这是首次报道幼儿Ph+ CML伴绿色瘤作为原始细胞转化的孤立髓外定位。据推测，诸如炎症等局部事件可能诱导髓外原始细胞转化。
