Abstract
Myeloid sarcoma is a rare extramedullary tumor of immature myeloid cells. Certain known acute myeloid leukemia cytogenetic abnormalities, in particular t(8,21), has been associated with a higher incidence. Myeloid sarcoma, which rarely happens in acute promyelocytic leukemias, is more common in recurrent patients after the advent of all-trans retinoic acid (ATRA) and are rare in untreated acute promyelocytic leukemia. We described a case of, to our knowledge, de novo myeloid sarcoma of the spine confirmed as acute promyelocytic leukemia. Myeloid sarcoma is diagnosed by spinal tumor biopsy, and microscopic examination of a bone marrow smear and cytogenetic analysis led to a confirmed diagnosis of acute promyelocytic leukemia.
Highlights
Myeloid sarcoma (MS), known as granulocytic sarcoma or chloroma, is a rare extramedullary tumor of immature myeloid cells [1]
After 14 days of surgery, peripheral blood (PB) film examination showed 13% promyelocytes, and bone marrow (BM) aspirate showed that granulocytes accounted for 70%, with 50% promyelocytes that varied in diameter and contained rich cytoplasm with abundant small azurophilic granules
As a special type of acute myeloid leukemia (AML), acute promyelocytic leukemia (APL) is characterized by a block in differentiation where leukemic cells are halted at the promyelocyte stage, accounting for roughly 5%–8% of AML patients
Summary
Myeloid sarcoma (MS), known as granulocytic sarcoma or chloroma, is a rare extramedullary tumor of immature myeloid cells [1]. After 14 days of surgery, peripheral blood (PB) film examination showed 13% promyelocytes, and bone marrow (BM) aspirate showed that granulocytes accounted for 70%, with 50% promyelocytes that varied in diameter and contained rich cytoplasm with abundant small azurophilic granules. These leukemic cells did not contain Auer rods (Figure 3). Retrospective fluorescence in situ hybridization (FISH) testing for the PML-RARa fusion gene was conducted on samples of excised tumor in March and showed positive results with t(15:17)(q24;q21) as well (Figure 2). After 10 months of follow-up, the patient still remained in complete hematologic and molecular remission
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