1/279. Mediastinal B-cell high grade non-Hodgkin's lymphoma with sclerosis: report of three cases. Mediastinal large B-cell lymphomas are uncommon haematologic malignancies seen mostly in women. We report our recent experience with three patients, only one of whom survived after an autologous bone marrow transplantation. ( info) |
2/279. Ocular adnexal granulocytic sarcoma as the first sign of acute myelogenous leukemia relapse. PURPOSE: To report a case of granulocytic sarcoma involving the eyelids and caruncles after bone marrow transplantation. methods: Case report. A 30-year-old man with acute myeloid leukemia in remission developed multiple friable eyelid and caruncular lesions in addition to two cutaneous lesions on the chest wall and right axilla approximately 3 months after a successful autologous bone marrow transplant. RESULT: Pathologic examination was consistent with granulocytic sarcoma. CONCLUSION: This condition should be considered in the differential diagnosis of cutaneous or eyelid masses in patients with a history of leukemia. ( info) |
3/279. Extramedullary tumors of myeloid blasts in adults as a pattern of relapse following allogeneic bone marrow transplantation. BACKGROUND: Extramedullary tumors of lymphoid and myeloid blasts outside the well-defined sanctuaries following allogeneic bone marrow transplantation (allo-BMT) are rare. Little is known about the biology, treatment, and outcome of these tumors in this setting. methods: In this retrospective analysis, 134 consecutive patients with acute myeloid leukemia (AML) or chronic myeloid leukemia (CML) who underwent allo-BMT at a single institution between 1990 and 1998 were reviewed. Five cases of isolated extramedullary myeloid sarcoma that occurred as patterns of recurrence following allo-BMT between 1990 and 1998 are reported. These patients were treated with radiotherapy, systemic chemotherapy, or a second allo-BMT. Clinical outcome is compared with posttransplantation bone marrow relapses observed during the same period at the same institution. The literature on the clinical characteristics, currently available treatment, and outcome of posttransplantation myeloid sarcoma patients was reviewed. RESULTS: Excluding isolated skin and central nervous system recurrences, the frequency of extramedullary myeloid sarcoma encountered as a relapse pattern following allo-BMT was determined to be 3.7% among patients with acute or chronic leukemia of myeloid origin. The survival of patients who were managed with radiotherapy and systemic chemotherapy was less than 4 months. A patient who underwent a second allo-BMT following local radiotherapy is alive and in complete remission more than 33 months after the diagnosis of myeloid sarcoma. The median survival of 17 patients with posttransplantation bone marrow relapse following allo-BMT was 2.2 months. When posttransplantation medullary recurrences are analyzed, patients with CML had a median survival of 12 months, with a significantly better 5-year survival rate than patients with AML (0 vs. 60%, P = 0.015; median survival, 12 months). CONCLUSIONS: The clinical outcomes of patients with recurrent isolated extramedullary myeloid sarcoma following allo-BMT are poor, as in any leukemic relapse, with the exception of patients with CML in this setting. ( info) |
4/279. Myelodysplastic syndrome and associated skin lesions: a review of the literature. The skin involvement of the myelodysplastic syndrome (MDS) can take the form of either a neoplastic infiltration or various non specific lesions. The occurrence of these lesions may be the presenting feature of the disease (MDS) or may herald its progression to acute leukemia. Recognition and early diagnosis have therapeutic and prognostic significance. ( info) |
5/279. Leukemia cutis in acute lymphocytic leukemia masquerading as viral exanthem. Leukemia cutis is a specific skin lesion caused by infiltration of leukemic cells into the skin. It is uncommon in acute lymphocytic leukemia (ALL). It typically manifests as red or violaceous papules, nodules, or plaques, mainly on the face. Leukemia cutis presenting with a generalized viral exanthem-like maculopapular eruption appears to be rare in the English literature. We report such a case. A 19 year-old man presented with a generalized purpuric maculopapular eruption of eight day's duration. Hematologic studies showed changes of acute lymphocytic leukemia, t-cell type. A skin biopsy specimen revealed a cuff-like, dense, perivascular infiltration of atypical lymphocytes in the upper and mid-dermis, consistent with leukemia cutis. The rash resolved in two weeks after chemotherapy. Our case illustrates that leukemia cutis should be considered in the differential diagnosis of a generalized morbilliform viral exanthem-like eruptions. skin biopsy is important in establishing the diagnosis. ( info) |
6/279. Specific cutaneous lesions of the scalp in myelodysplastic syndrome with deletion of 20q. We reported a specific skin lesion on the scalp in a patient with myelodysplastic syndrome (MDS), treated as refractory anemia with excess of blasts (RAEB). Histologically, a specimen from a nodule of the scalp consisted of a diffuse infiltration of atypical cells in the dermis and subcutaneous tissue. The patient died of acute leukemia 3 months later. Chromosomal examination of bone marrow cells revealed deletion of 20q and 21 trisomy. The specific cutaneous lesions in this patient were associated with acute transformation. The deletion of 20q and specific cutaneous lesions are regarded as signs of poor prognosis. ( info) |
7/279. Granulocytic sarcoma (chloroma) of the small intestine. Granulocytic sarcoma or Chloroma may develop before, at the time or after presentation of acute myeloid leukemia. We report the case of a 66-year old man presenting with intermittent abdominal pain during one month before developing a peritonitis due to perforation of small bowel followed by irreversible shock and death. Nearly the entire length of small bowel and bone marrow were infiltrated by giant promyelocytic cells. Abnormal circulating cells were never discovered. The literature is briefly reviewed. ( info) |
8/279. Leukemic macrocheilia associated with chronic lymphocytic leukemia. Specific cutaneous infiltrates in chronic lymphocytic leukemia presenting as a tumor or a large nodule on the face, scalp, and upper trunk are rare; involvement of the oral mucosa is extremely rare. We report a case of leukemic macrocheilia that occurred three years before a diagnosis of chronic lymphocytic leukemia was made. ( info) |
9/279. Sinus polyp-associated soft tissue lesion and unilateral blindness: complications of extraction in leukemic patient. A case of an inflammatory polyp-associated lesion extending through an extraction socket appearing as an intraoral nodular lesion and unilateral blindness secondary to leukemic optic nerve head infiltration is reported. The patient was a 28-year-old male whose his upper first molar had been extracted fifteen days previously. The lesion was an asymptomatic soft tissue mass, red in color and hot tender to palpation, involving the alveolar ridge in the maxillary molar area. Although this is apparently a rare occurrence, the nature of the lesion was suggested by the history, clinical appearance, and radiographic findings. Excision of the inflammatory lesion was followed by complete healing with closure of the lesion. Unfortunately, the blindness was irreversible. The patient is still under leukemia therapy. review of the literature did not yield any other such cases. The role of oral lesions as a diagnostic indicator and the importance of dental surgeons in the diagnosis of leukemic patients are discussed. It is concluded that proper precautions and meticulous early diagnosis are required in these patients and that dental practitioners should be aware of the diagnostic features and possibilities of oral complications associated with leukemia. ( info) |
10/279. Monocytic aleukemic leukemia cutis. The authors present a case of monocytic aleukemic leukemia cutis in which skin symptoms were the sole manifestation of the leukemia during the first year and a half of the disease. Diagnostic difficulties, the importance of immunohistochemical markers, and the prognosis and therapy of aleukemic leukemia cutis are discussed. ( info) |