Acute Lymphoblastic Leukemia Relapse in the Breast: Fine Needle Aspiration Diagnosis of a Rare Presentation

Driss, Maha; Salem, Azza; Mrad, Karima; Abbès, Imen; Sassi, Samia; Romdhane, Khaled Ben

doi:10.1159/000325054

Cited by 5 publications

(3 citation statements)

References 13 publications

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“…Similar, almost universal, response to therapy was seen among the 19 post‐transplant cases (17 allogeneic, two autologous), which were short‐lived in most cases. Of the six treated with local therapy alone, one had no obtainable follow‐up after radiation [58] , one relapsed in marrow while undergoing radiation [59], and four had early extramedullary relapses [60–62, Selleri C. Unpublished case. 2002].…”

Section: Resultsmentioning

confidence: 99%

A basis for updating our approach to resistant acute leukemia

Cunningham

2012

American J Hematol

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No studies exist documenting that chemotherapy alone eradicates tumors composed of leukemic cells in a large group of patients with tumors at any one site. Yet, its use has continued over 40 years in the absence of data. Consensus protocols exist only for testis and meningeal tumors, relying on local therapy. To constitute a body of knowledge about tumors at one site, the breast was chosen and all published cases were analyzed, with follow-up obtained, to document the behavior of acute leukemia tumors and survival after presentation. Among 235 cases (52% published since 2000), overall survival was poor, particularly for the 43% with concurrent morphologic marrow relapse, with 66-73% one-year mortality. Only 4 of 106 patients treated with chemotherapy alone survived 4 years. The majority of AML and ALL tumors were only transiently responsive to anti-leukemia treatments, including transplant, and next relapses were as, or more, common in further tumors than in marrow. A pattern of tumors similar to the metastases of invasive lobular breast cancer was revealed. When relapse occurred in marrow, durable remission was only rarely obtained. These data suggest a potential benefit of incorporating extent of disease workup at diagnosis and relapse into prospective trials. This could yield an accurate incidence of extramedullary tumors and a means to identify occult residual disease which could lead to marrow relapse. This approach could potentially result in greater success in curing acute leukemias. Am. J. Hematol. 87:251-257, 2012. V

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Section: Resultsmentioning

confidence: 99%

A basis for updating our approach to resistant acute leukemia

Cunningham

2012

American J Hematol

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“…Mitotic figures may be present and variable in number. [78] Ninety percent are T-cell neoplasms and stain for these markers and the remaining 10% are B-cell type. ALL is the only lymphoma that shows TdT positively.…”

Section: Discussionmentioning

confidence: 99%

“…These include non-Hodgkin's lymphoma, rhabdomyosarcoma, granulocytic sarcoma, lobular carcinoma, neuroblastoma and endocrine carcinoma. [7]…”

Section: Discussionmentioning

confidence: 99%

Acute lymphoblastic leukemia presenting as a breast lump: A report of two cases

Besina

Rasool

Samoon

et al. 2013

J Cytol

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Extra-medullary leukemic infiltration of the breast by acute lymphoblastic leukemia (ALL) is very rare. We report two cases of ALL presenting as breast masses and diagnosed on fine-needle aspiration (FNA). Our first patient, a post-partum 30-year-old female, developed bilateral breast lumps in her last trimester of pregnancy and complained of easy fatigability. Our second patient, a 14-year-old girl, presented with a right-breast lump of 1-week duration. She had received treatment for ALL 1 year back and had been in complete remission for the last 1 year. FNA of the breast nodules done in both the cases revealed diffuse infiltration by lymphoblasts. Subsequent hematological investigations confirmed bone marrow involvement by ALL in the first case and extra-medullary relapse in the second case. Fine-needle aspiration cytology (FNAC) is an easy and cost effective method for the early diagnosis of metastatic leukemic infiltration, avoiding unnecessary excisional biopsies in such cases.

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Ovarian/Primary Peritoneal Carcinoma

Davidson

2011

Serous Effusions

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Acute Lymphoblastic Leukemia Relapse in the Breast: Fine Needle Aspiration Diagnosis of a Rare Presentation

Cited by 5 publications

References 13 publications

A basis for updating our approach to resistant acute leukemia

A basis for updating our approach to resistant acute leukemia

Acute lymphoblastic leukemia presenting as a breast lump: A report of two cases

Ovarian/Primary Peritoneal Carcinoma

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