Hematological malignancies can manifest as extramedullary soft tissue masses in relatively rare cases. The rarity of it causes a diagnostic and therapeutic challenge. One of the rarest manifestations is myeloid sarcoma (MS). MS develops as part of acute myeloid leukemia, myeloproliferative neoplasm, or myelodysplastic syndrome or at relapse, especially following allogeneic hematopoietic stem cell transplant. The tumor displays high myeloperoxidase expression, hence the color green, and is called chloroma. It most commonly appears in lymph nodes, skin and soft tissues, bone, testes, gastrointestinal tract, and peritoneum. Immunohistochemistry shows CD68-KP1 as the most commonly expressed marker, then myeloperoxidase, CD117, CD99, CD68/PG-M1, lysozyme, CD34, terminal deoxynucleotidyl transferase, CD56, CD61, CD30, glycophorin A, and CD4. Different chromosomal abnormalities including MLL rearrangement, t(8; 21), monosomy 7, trisomy 8, trisomy 11, trisomy 4, inversion (16), monosomy 16,16q deletion, 5q deletion, and 20q deletion were reported. Most of the literature about MS are case reports and small retrospective studies, thus there is limited clinical knowledge of the cases and their presentation and management plans. Here, we provide a review of what has been reported in the literature about MS in the light of our experiences.

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(1) Background: Neck pain is the most common type of musculoskeletal problem affecting office workers. Various occupational risk factors have been linked to neck pain. This study aims to assess the prevalence and risk factors of neck pain among office workers at the Ministry of Health in Saudi Arabia. (2) Methods: A cross-sectional study was conducted, and the participants completed an online questionnaire based on the Standardized Nordic questionnaire and Quality of Life Scale Brief Version to evaluate their neck pain and the physical, psychological, social, and environmental factors that might affect their conditions. A descriptive analysis was conducted for the data and a logistic regression was performed to ascertain the effects of biodemographic and occupational factors on the likelihood of having neck pain. (3) Results: A total of 413 subjects (176 females and 237 males) participated in our study with an average age of 33.6 ± 8 years. The prevalence of neck pain in our participants was 64% during a twelve-month period. Females were less likely to suffer neck pain than males (OR = 0.52, 95%CI [0.30,0.87]), and age, BMI, level of education, and profession were not associated with likelihood of having neck pain. However, reduced working hours were associated with a reduction in the likelihood of having neck pain (OR = 0.42, 95%CI [0.33,0.53]). (4) Conclusion: Neck pain affects a large proportion of the office workers at the Ministry of Health, and this pain is significantly associated with long working hours and males. Thus, there is a need for future research that can investigate how associated factors can be managed to reduce the long-term impact of neck pain on workers’ lives. Quality improvement approaches might be used to implement effective interventions for the prevention and management of work-related risk factors that can cause neck pain.

The prognosis of acute myeloid leukemia (AML) is poor because of relapses occurring on conventional chemotherapy. The distinction between leukemic and normal stem cells relies on the expression of antigen combinations defining leukemia-associated immunophenotypes (LAIPs), which are absent or extremely infrequent in normal bone marrow. However, LAIPs are very different from patient to patient and are not necessarily stable over the course of the disease. Accordingly, we addressed the applicability of human myeloid inhibitory C-lectin (hMICL) by flow cytometry as a specific leukemic myeloid stem cell marker for the diagnosis of AML in CD34 and CD34 cases and evaluated the stability of hMICL during the course of the disease. hMICL expression was assessed in 78 bone marrow aspirate specimens obtained from AML patients at diagnosis (n = 40), complete remission (CR) (n = 28), and relapse (n = 10). AML patients at diagnosis were compared to 20 newly diagnosed acute lymphoblastic leukemia (ALL) patients and 20 healthy controls. hMICL was reevaluated in CR and relapse specimens. hMICL was expressed in 100% AML patients at diagnosis (mean ± standard deviation [SD], 60.3 ± 19.9%), both CD34 and CD34 , but not in ALL (mean ± SD, 3.3 ± 1.9%) or healthy controls (mean ± SD, 3.4 ± 2.6%) (P < .001). hMICL median fluorescence intensity ratio was higher in AML (mean ± SD, 15.9 ± 11.7) compared to ALL (mean ± SD, 4.5 ± 1.4) and healthy controls (mean ± SD, 4.4 ± 1.6) (P < .001). hMICL was expressed in all studied AML morphologic subtypes. Preserved stable expression of hMICL was found in CR and relapse specimens with no antigen loss. hMICL is a robust pan-AML-associated antigen with excellent diagnostic impact, extreme specificity to AML blasts, and stability throughout the course of the disease. hMICL could be incorporated into the routine flow cytometry setting within the initial diagnostic work-up and follow-up of AML.