Weide R, Wacker H H, Köppler H, Görg C, Pflüger K H, Havemann K
Department of Haematology/Oncology, Philipps-University, Marburg, Germany.
Leuk Lymphoma. 1996 Aug;22(5-6):527-9. doi: 10.3109/10428199609054794.
A patient with acute monoblastic leukemia (AML, M5A) was treated successfully in December 1987. In 1993 after 6 years in complete remission, she presented with an intracutaneous nodular mass on her right upper arm which was resected in toto and shown to be undifferentiated monoblastic leukemia. Two further chloroma lesions were excised in July 1994 and March 1995 respectively. Bone marrow cytology and histology always showed a continuing complete remission with no evidence of leukemia relapse. In July 1995 she presented with a disseminated skin infiltrate and a relapse with 80% monoblasts in the bone marrow. After one course of chemotherapy (Idarubicin/Ara-C), a second complete remission was achieved and her leukemic skin infiltrate disappeared completely. This case illustrates that chloromas of the skin can occur as late as 6 years after treatment for AML and also emphasizes that the occurrence of a chloroma does not necessarily mean immediate leukemia relapse. It also stresses that a second complete remission can be achieved with standard AML-induction therapy despite widespread leukemic skin infiltrates in such patients.
一名急性单核细胞白血病（AML，M5A）患者于1987年12月得到成功治疗。1993年，在完全缓解6年后，她右上臂出现一个皮内结节性肿块，该肿块被完整切除，病理显示为未分化单核细胞白血病。1994年7月和1995年3月又分别切除了另外两个绿色瘤病灶。骨髓细胞学和组织学检查始终显示持续完全缓解，无白血病复发迹象。1995年7月，她出现弥漫性皮肤浸润，骨髓中单核细胞比例达80%，白血病复发。经过一个疗程的化疗（伊达比星/阿糖胞苷），再次实现完全缓解，其白血病性皮肤浸润完全消失。该病例表明，AML治疗后6年仍可出现皮肤绿色瘤，同时强调绿色瘤的出现不一定意味着白血病立即复发。它还强调，尽管此类患者存在广泛的白血病性皮肤浸润，但采用标准的AML诱导化疗仍可实现再次完全缓解。
