Acute myelofibrosis and malignant hypercalcemia

Thorotrast administration followed by myelofibrosis

“…The findings suggest a terminal blastic phase to the patient's illness, and the probable transition to an acute leukaemia. Similar marrow changes at postmortem have been seen in recent cases of acute myelofibrosis, with hypercellularity and infiltration with blast cells (Lubin et al, 1976;Libnoch et al, 1977).…”

“…Since cases of advanced chronic myelofibrosis often have a considerable number of blasts in the peripheral blood, and since the exact significance of histological evidence of extra-medullary haemopoiesis is uncertain (Modan, 1975), it is difficult to judge whether these cases of acute myelofibrosis are really acute leukaemias. Despite this difficulty in nomenclature such acute cases undoubtedly occur, with several recent case reports in the literature (Lubin, Rozen and Rywlin, 1976;Libnoch et al, 1977). There has been one case report of the apparent co-existence of acute myelofibrosis and acute myeloid leukaemia (Patel, Shah and Rhee, 1976).…”

Hypercalcemia and diffuse osteolytic lesions in a 45-year-old patient with myeloid sarcoma with megakaryocytic differentiation

“…Osteolytic lesions on the other hand are exceedingly rare ( 4 , 5 ). In combination with hypercalcemia, occurrence of lytic lesions has been associated with accelerated and blastic phases of myelofibrosis (‘acute myelofibrosis’), a rapid disease course, and poor prognosis ( 6 ).…”