Cyto-morphological features of extramedullary acute megakaryoblastic leukemia on fine needle aspiration and cerebrospinal fluid cytology: A case report

Chitragar, Sanjeev; Agarwal, Shipra; Iyer, Venkateswaran K.; Mathur, Sandeep; Karak, Asis Kumar; Chharchhodawala, Taher; Sharma, Atul; Bakhshi, Sameer

doi:10.4103/1742-6413.85496

Cited by 7 publications

(1 citation statement)

References 21 publications

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“…In childhood AML cases, EML at diagnosis involved the orbits, skin and epidural sites . In addition to manifestations of obviously emergent EML ( e.g ., superior vena cava syndrome, pleural effusions, cord compression), sites of EML involvement requiring immediate attention have included the cerebrospinal fluid, small bowel, peritoneum, liver, pancreas and retroperitoneum . Authors reported cervical EML with postmenopausal bleeding and vaginal EML with urinary incontinence .…”

Section: Clinical Presentations Of Emlmentioning

confidence: 99%

Is acute myeloid leukemia a liquid tumor?

Ohanian

Faderl

Ravandi

et al. 2013

Intl Journal of Cancer

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Extramedullary manifestations of acute myeloid leukemia (AML) were described as early as the 19th century. However, the incidence, clinical significance, and pathobiology of extramedullary AML remain ill defined. We reviewed case reports, retrospective case series, pilot studies, and imaging studies of extramedullary leukemia (EML) to determine its frequency, characteristics, clinical presentation, and significance. EML precedes or accompanies development of AML and occurs during or following treatment, even during remission. Although imaging studies are rarely conducted and the true incidence of EML has yet to be verified, authors have reported several estimates based on retrospective and autopsy studies. The incidence of EML in patients with AML of all ages is estimated to be about 9% and EML in children with AML was detected in 40% of patients at diagnosis. The combination of positron emission tomography and computed tomography were the most sensitive and reliable techniques of detecting and monitoring EML. Based on our literature review, the frequency of EML is likely underreported. The well-documented nature of EML in AML patients suggests that AML can manifest as a solid tumor. The extent to which EML accompanies AML and whether EML is derived from bone marrow are unknown. Furthermore, questions remain regarding the role of the microenvironment, which may or may not facilitate the survival and proliferation of EML, and the implications of these interactions with regard to minimal residual disease, tumor cell quiescence, and relapse. Therefore, prospective studies of detection and characterization of EML in AML patients are warranted.

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