Granulocytic Sarcoma Preceding Acute Myeloid Leukaemia

Ersbøll, Jens; Petri, Jens; Jensen, Klaus Hou; Hansen, Mogens

doi:10.1111/j.1600-0609.1980.tb02761.x

Cited by 9 publications

(3 citation statements)

References 32 publications

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“…Obstructive jaundice has only rarely been observed as the presenting feature of AML, and only with small duct cholestatic features 1. It has been described in case reports as resulting from granulocytic sarcoma and leukaemic infiltration of the liver 2. This is the first reported case of AML presenting with large bile duct strictures.…”

Section: Discussionmentioning

confidence: 93%

“…A cholestatic picture in the context of AML is sometimes associated with chemotherapy 1. There are case reports of AML presenting as cholestatic jaundice as a result of hepatic sinusoidal infiltration, which usually resolves following cessation of chemotherapy 2. This case was an unusual presentation with large duct strictures, with no evidence of small duct obstruction or sinusoidal infiltration at liver biopsy.…”

Section: Introductionmentioning

confidence: 89%

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Acute myeloid leukaemia: an unusual cause of biliary strictures

et al. 2019

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A 17-year-old man with no significant past medical history presented with a 2-week history of worsening jaundice, lethargy, anorexia and progressive right upper quadrant abdominal pain. There were no stigmata of chronic liver disease. Initial investigations were suggestive of cholangitis with large intrahepatic and extrahepatic bile duct strictures but otherwise normal hepatic and splenic appearances. A percutaneous transhepatic cholangiogram with the positioning of drains was performed to alleviate the obstructive jaundice. Within 2 weeks of the first presentation, full blood count revealed a significantly raised white blood count and a subsequent peripheral blood smear and bone marrow were consistent with a diagnosis of acute myeloid leukaemia. Chemotherapy was started after partial improvement of his obstructive jaundice. Complete morphological and cytogenetic remission was obtained 4 weeks after the first cycle of chemotherapy (half dose of daunorubicin and full dose of cytarabine, treated off trial) on control bone marrow. The patient remains in remission.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 89%

Acute myeloid leukaemia: an unusual cause of biliary strictures

et al. 2019

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“…Among the 110 cases found to have no marrow leukemia on presentation, 64 involved the small intestine; most of which presented with obstruction of duodenum, jejunum or ileum, and 4 presented with intussusception . Most of the small intestine cases were evaluated only by CT or MRI scans, only 5 by PET scans.…”

Section: Resultsmentioning

confidence: 99%

Leukemia in gastrointestinal organs as cause of treatment failure: 378 cases analyzed

Cunningham

Worthley

2018

American J Hematol

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Leukemia growing as tumors in gastrointestinal organs is an under-investigated cause of treatment failure and death. These present with symptoms often mistaken for common toxicities but may grow large before symptoms. To synthesize experience available only in case reports, 378 were analyzed. Invasive and metastatic behavior typical of solid GI tumors was revealed even when marrow was uninvolved. Within 3 months of diagnosis, 33% had died, 47% within 1 year. Survivals of 4 to 18 years after involvement suggest cure is possible. Evidence is presented that combined local and systemic therapy has successfully treated GI leukemic tumors when identified early.

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Acute myelocytic leukemia manifested by prominent generalized lymphadenopathy: Report of two cases with immunological, ultrastructural, and cytochemical studies

et al. 1986

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Although it is well recognized that granulocytic sarcoma can cause localized lymphadenopathy, widespread nodal involvement by acute myelocytic leukemia (AML), clinically mimicking non-Hodgkin's lymphoma, has only been previously described twice. We report the clinicopathological, immunological, and cytochemical features of two patients who had widespread, prominent lymphadenopathy secondary to AML as well as concurrent marrow leukemia (M1 and M2). For one patient the lymphadenopathy was the predominant abnormality prompting him to seek medical attention, while the second patient had symptoms of infection following a 9-month history of myelodysplasia. The disease in both patients was aggressive; one patient survived only 1 week and the other survived only 5 weeks after diagnosis. In both cases the granulocytic sarcoma was confirmed by cytochemistry studies (naphthol ASD-chloroacetate esterase on tissue sections and myeloperoxidase on imprint smears), and electron microscopy, including morphology (both cases) or ultrastructural localization of myeloperoxidase (case 2). Non-specific esterase activity was not detected in either patient's blasts, although serum lysozyme was elevated in both cases. Immunological studies revealed reactivity of both patients' cells with panleukocyte, MY4, MY7, OKM-1, and Leu-M1 monoclonal antibodies and with alpha-1-antitrypsin and muramidase antibodies. The cells of one of these patients also reacted with anti-S-100 protein. Although the cytochemical studies indicated that both cases exhibited only myeloid differentiation, the immunological markers suggested that the tumor cells possessed some features of monocytes, perhaps explaining their propensity for widespread tumor formation. Morphological, immunological, cytochemical, and ultrastructural methods of diagnosing granulocytic sarcoma are presented.

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Granulocytic Sarcoma Preceding Acute Myeloid Leukaemia

Cited by 9 publications

References 32 publications

Acute myeloid leukaemia: an unusual cause of biliary strictures

Acute myeloid leukaemia: an unusual cause of biliary strictures

Leukemia in gastrointestinal organs as cause of treatment failure: 378 cases analyzed

Acute myelocytic leukemia manifested by prominent generalized lymphadenopathy: Report of two cases with immunological, ultrastructural, and cytochemical studies

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