Kahn D G
Department of Pathology, Olive View-University of California, Los Angeles, Medical Center, Sylmar, USA.
Arch Pathol Lab Med. 1998 Apr;122(4):375-8.
A case of a 25-year-old man who presented with low back, knee, and hip pain with bruising, leukocytosis, and thrombocytopenia is reported. Histopathologic and flow cytometric studies revealed a malignant neoplasm, which was thought to be consistent with an unusual type of acute leukemia. Subsequent immunohistochemical studies revealed diffuse bone marrow involvement by rhabdomyosarcoma, demonstrated by positivity for desmin and muscle-specific actin. In addition, the diagnosis of metastatic rhabdomyosarcoma was confirmed with cytogenetic and ultrastructural studies. The incidence of rhabdomyosarcoma, a disease usually seen in childhood, presenting with extensive bone marrow involvement and mimicking acute leukemia in an adult is extremely rare. This case highlights the need to consider rhabdomyosarcoma in the differential diagnosis in patients who present with a leukemic picture and atypical blasts that lack the usual hematopoietic markers.
报告了一例25岁男性病例，该患者出现腰、膝和髋部疼痛，并伴有瘀斑、白细胞增多和血小板减少。组织病理学和流式细胞术研究显示为恶性肿瘤，被认为与一种不寻常类型的急性白血病相符。随后的免疫组织化学研究显示横纹肌肉瘤弥漫性累及骨髓，结蛋白和肌肉特异性肌动蛋白阳性证实了这一点。此外，细胞遗传学和超微结构研究证实了转移性横纹肌肉瘤的诊断。横纹肌肉瘤通常见于儿童，在成人中表现为广泛的骨髓受累并酷似急性白血病，其发病率极其罕见。该病例强调，对于表现出白血病样症状且缺乏常见造血标志物的非典型原始细胞的患者，在鉴别诊断中需要考虑横纹肌肉瘤。
