Leukemia-like Picture Research Articles

Carcinocythemia with Microfilaria: Two Diverse Pathologies in One Case

Introduction: Carcinocythemia means circulating tumor cells in peripheral blood. It is a very rare finding I routine practice. The first ever case was reported in 1869 by Ashworth, but it was not till 1976 that the terminology carcinocythemia was coined by Cary et al [1,2]. Only a handful of cases have been reported in literature [3]. We present one such rare case which had an additional finding of micro-filaria in it. Case Report: A 60-year-old male patient, hailing from Eastern Ghats of India, presented to the emergency with sudden onset paresis of bilateral lower limbs, hemoptysis, abdominal distention, and urine retention, constipation and persistent chest pain. On evaluation the power of bilateral lower limb was ¼. He was a known case of Stage IV adenocarcinoma of lungs with bilateral adrenal metastasis. He had received four cycles of PEM + Carboplatin followed by 3 cycles of Carboplatin and Paclitaxel. Last dose of chemotherapy was administered fifteen days prior to presentation. The patient was not responding to chemotherapy. He was receiving blood transfusion. The peripheral smear of the patient revealed circulating tumor cells along with micro-filaria. Cell block was prepared from the sample but unfortunately did not reveal much for special staining. The species of filaria was that of Wuchereria bankrofti. Interestingly, the patient lacked eosinophilia. The total count was 11,000/cumm; Hemoglobin: 8.2gm/dl and Platelet count was 2,10,000/cumm. The counter had flagged for atypical lymphocytes. The patient deteriorated fast and expired within few hours of presentation. Thus, further evaluation was not possible. Conclusion: Carcinocythemia is a rare phenomenon but as a hemato-pathologist vigilance is mandated while evaluating peripheral blood smears to detect such extra-ordinary findings.

Erythropoietin-induced acute erythroid leukemia-like picture: A potential pitfall

A 31-year-old male patient presented with fever and pancytopenia. He was diagnosed as a case of chronic anemia since early childhood. The etiology of the anemia was not known. The patient was transfusion dependent, and he had been maintained on erythropoietin for three years prior to admission. A bone marrow examination revealed prominent proliferation of immature and dysplastic erythroid precursors. Acute erythroid leukemia of the pure erythroid subtype was suspected. However, because of the history of erythropoietin therapy a definite diagnosis was not made. On follow-up one month later, the marrow changes had reversed to normal.

ESTABLISHMENT AND CHARACTERIZATION OF A HEPATOBLASTOMA CELL-LINE FROM A PATIENT WITH SECONDARY ACUTE MYELOID-LEUKEMIA

A girl who had been treated, apparently successfully, with surgery and chemotherapy for a hepatoblastoma, fell ill two years later with what was diagnosed as an AMF M(4). A cell line was established from her peripheral blood. This cell line had epithelial morphology and grew both in suspension culture and as a monolayer. The cells were positive for epithelial surface markers, including the liver-specific alpha-fetoprotein, but not for leukocyte markers. The cell-line's karyotype was markedly abnormal. It did not have any specific aneuploidies or any other aberrations characteristic of leukemias; instead it had gains of 2q and chromosome 20, the most common cytogenetic changes in hepatoblastoma. It is most likely that the patient had a relapse of hepatoblastoma with massive seeding of the blood leading to a leukemia-like picture without, of course, excluding other possibilities.

Ovarian rhabdomyosarcoma presenting as leukemia case report

A condition of pure ovarian rhabdomyosarcoma in a 16-year-old female is described. The tumor presented with a leukemia-like picture, with extensive peripheral blood and bone marrow involvement which led to an initial diagnosis of acute lymphoblastic leukemia. The diagnosis was achieved at autopsy and was supported by ultrastructural findings of Z-band-like material and alternating thin and thick filaments.

Group-C Trisomy in Myeloid Metaplasia with Possible Leukemia

Abstract A chromosomal abnormality in marrow and blood cells has been found in only one patient out of a group of 20 subjects with myeloproliferative disorders other than leukemia. The abnormal karyotypic finding consisted of group C9 trisomy in a patient with myeloid metaplasia and an acute leukemia-like picture and indicates a definite relationship to acute leukemia. The latter has been shown to be not infrequently accompanied by C9 trisomy. The trisomy was accompanied by the presence of a substantial number of hypertetraploid cells in the marrow but not in the cultured blood cells. As a matter of fact, the blood culture yielded predominantly metaphases with 47 chromosomes (C9 trisomy) on the first examination and metaphases with 46 chromosomes and a normal female karyotype on the second occasion. The superiority of bone marrow karyotype analysis over that of blood cells in leukemic states is thus indicated.

Comparison of Chromosome Constitution in Chronic Myelocytic Leukemia and Other Myeloproliferative Disorders

Abstract The frequency of the Ph1 chromosome in freshly aspirated marrow cells of 14 patients with typical chronic myelocytic leukemia processed by a "direct technic" without resort to culture or colchicine was significantly higher (> 75 per cent) than that observed in the cultured blood cells (< 35 per cent) of the same subjects. The karyotypic abnormally of the abbreviated G-group chromosome would appear not to be related to therapy, since the frequency with which it occurred was not materially affected by treatment (including radiation). The Ph1 chromosome was not observed in any of the metaphases of blood or marrow of 12 subjects who had developed a leukemia-like picture complicating either myelofibrosis, polycythemia vera or myeloid metaplasia. A new chromosome abnormality—a shortened D-group chromosome—was observed with about the same frequency in the blood and marrow metaphases of a female patient with treated chronic myelocytic leukemia. This new karyotypic abnormality was associated with the highest frequency of the Ph1 chromosome in cultured blood cells in the group studied. The Ph1 chromosome was observed in the metaphases of a patient with the blastic phase of chronic myelocytic leukemia. The variations of the morphology of the Ph1 chromosome are discussed and illustrated, especially in relation to the Y-chromosome. In four patients with an atypical picture of CML, the Ph1 chromosome was not observed either in the marrow or cultured blood.