Pérez del Río M J, Fresno Forcelledo M F, Ramírez Páyer A, Ablanedo Ablanedo P, Luño Fernández E, Fanjul Colunga E, Herrero Zapatero A
Servicio de Anatomía Patológica, Hospital Ntra. Sra. de Covadonga, Universidad de Oviedo.
Sangre (Barc). 1998 Jun;43(3):236-9.
We report a case of alveolar rhabdomyosarcoma (AR) with massive infiltration of bone marrow at presentation, and initial diagnosis in bone marrow aspirate. A 35 year old man presented with a submandibular mass, and hematomas after mild traumatisms. Peripheral blood showed thrombocytopenia and a normocytic anaemia. Bone marrow film showed diffuse involvement by undifferentiated blasts with rhabdomyoblastic features. Subsequent biopsy of submandibular lymph node confirmed the diagnosis with positivity for specific muscle actin and desmin, and negativity for lymphoid markers. Initial presentation of AR with extensive bone marrow involvement is extremely rare, and it could lead to wrong diagnosis and treatment of acute leukaemia, with the serious consequences that this would have. Immunohistochemical study and morphologic differential features can be of great diagnostic help.
我们报告一例肺泡横纹肌肉瘤（AR），该病例在初诊时骨髓有大量浸润，且骨髓穿刺涂片做出了初步诊断。一名35岁男性患者出现下颌下肿块，并在轻度外伤后出现血肿。外周血显示血小板减少和正细胞性贫血。骨髓涂片显示未分化母细胞弥漫性浸润，具有横纹肌母细胞特征。随后下颌下淋巴结活检确诊，特异性肌动蛋白和结蛋白呈阳性，淋巴标记物呈阴性。AR初诊时伴有广泛骨髓受累极为罕见，可能导致急性白血病的误诊和误治，从而产生严重后果。免疫组织化学研究和形态学鉴别特征对诊断有很大帮助。
