1/10. Extramedullary blast crisis of chronic myeloid leukemia after allogeneic hematopoietic stem cell transplantation mimicking aggressive, translocation t(14;18)-positive B-cell lymphoma.We report the case of a 42-year-old male patient who was diagnosed with a large tumor of the right thoracic aperture 30 months after unrelated hematopoietic stem cell transplantation (HSCT) for accelerated phase of philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML). biopsy revealed an immature lymphoid neoplasia with blastic tumor cell morphology and immunoreactivity for CD34, CD79a, CD43, and CD30 as well as slight positivity for TdT and CD20. Bcr-Abl rearrangement was found in interphase tumor cell nuclei by fluorescence in situ hybridization (FISH). Furthermore, a translocation t(14;18)(q32;q21) was amplified by polymerase chain reaction (PCR). Bone marrow (BM) examination showed regular hematopoiesis including a negative FISH analysis for Bcr-Abl and complete donor chimerism. Nested PCR from peripheral blood (PB), but not conventional PCR, was positive for the b3a2 Bcr-Abl transcript. Neither radiation nor intensive chemotherapy was capable of achieving a tumor remission, and the patient died from progressive disease 6 months later. Postmortem examinations showed a shift of immunophenotype with appearance of myeloperoxidase-positive tumor cells and loss of lymphoid antigens. In addition, there were characteristic cytogenetic findings of multiple Ph chromosomes and a clonal loss of P53 tumor suppressor gene. The latter was already deleted before HSCT. We conclude that lymphoid neoplasia occurring in our patient should be interpreted as an extramedullary, very immature blast crisis of CML expressing lymphoid differentiation markers rather than a true de novo NHL.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
2/10. Acute myeloid leukemia with concurrent myeloid sarcoma treated with autologous bone marrow transplantation: two illustrative cases and a literature review.Myeloid sarcoma (MS) is an invasive extramedullary solid tumor composed of immature cells of the myeloid series. It complicates the clinical course of a minority of patients with acute myeloid leukemia (AML). Traditionally its presence has been regarded as an indicator of aggressive disease. Currently, the optimal treatment of AML with concurrent MS remains to be determined. We report two cases of autologous bone marrow transplantation (auto-BMT) for AML with concurrent MS followed by a review of the literature.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
3/10. Unusual leukemic presentation of rhabdomyosarcoma: report of two cases with immunological, ultrastructural and cytogenetical studies.BACKGROUND: Bone marrow infiltration occurs rarely at presentation of rhabdomyosarcoma (RMS) or other childhood solid tumors. This possibility leads to misdiagnosis of leukemia and incorrect therapies might be administered. methods: We report two patients presenting with diffuse bone marrows involvement by neoplastic cells. Initial studies were not consistent with a diagnosis of leukemia and the cases were further studied extensively by indirect immunofluorescence, immunocytochemistry, electron microscopy and cytogenetics. RESULTS: In both cases blast cells were large, poorly differentiated, with immunological reactivity to the anti-desmin antibody. Ultrastructural findings of muscular features and chromosomal translocation t(2;13) (q37;q14) further confirmed the diagnosis of rhabdomyosarcoma of the alveolar subtype. This was then confirmed histologically in one patient. CONCLUSION: This study stresses the utility of analyzing cases of morphologically undifferentiated marrow blast cells by various techniques, as well as investigating for different types of both hematological and solid neoplasms.- - - - - - - - - - ranking = 0.4keywords = leukemia (Clic here for more details about this article) |
4/10. Unusual postirradiation sarcoma of chest wall.This paper reports a sarcoma of the chest wall following postoperative radiation therapy for breast carcinoma. A total of 9346 rads was delivered at a 2-cm tissue depth from two treatment courses separated by a five-year interval. The sarcoma appeared 16 years following the initial radiation course. The existence of two mesenchymal elements in the lesion led to the final diagnosis of malignant mesenchymoma. Criteria for evaluating a possible radiation-induced malignancy are discussed.- - - - - - - - - - ranking = 19.512647511934keywords = radiation-induced (Clic here for more details about this article) |
5/10. Irradiation-induced pericarditis.Three patients with pericarditis following therapeutic irradiation for malignant tumors were studied at autopsy. In one subject, death occurred five days after the last dose of radiation. The pericardial involvement was characterized by fibrinous exudation. This was more marked in degree over the right side of the heart than the left and corresponded with the field of irradiation. In the remaining two patients, two and four courses of radiation had been applied, the interval between the last dose and death being seven weeks in one patiet and 1 1/2 years in the other. The lesions were those of organizing pericarditis.- - - - - - - - - - ranking = 78.050590047735keywords = radiation-induced (Clic here for more details about this article) |
6/10. Modified technique for radical transmediastinal forequarter amputation and chest wall resection.Forequarter or interscapulothoracic amputation is a major surgical procedure indicated primarily in the treatment of malignant lesions involving the bony and soft tissue parieties of the upper part of the arm, shoulder, and scapula. It is also indicated in extensive trauma with irreparable damage to the shoulder area and as a palliative measure in intractable pain caused by incurable tumors of the shoulder girdle. Several operative techniques have been described: the classical Berger approach, an anterior pectoral approach, and posterior retroscapular approaches. A radical transthoracic approach has been described in cases in which the tumor had spread through the chest wall. The two main goals of these approaches have been early ligation of the subclavian vessels and immediate exploration for operability. This report details our experience with a modified technique for radical forequarter amputation and chest wall resection in which a transmediastinal approach is employed. This approach was used in two patients: One had a radiation-induced fibrosarcoma of the left axilla and adjacent chest wall following a radical mastectomy 19 years earlier, and the other patient had a recurrent rhabdomyosarcoma of the right axilla with invasion of the chest wall. This technique avoids time-consuming and individual excision of ribs and minimizes the amount of blood loss by early ligation of the internal mammary vessels. Safe and excellent exposure and division of the subclavian vessels and early exploration for mediastinal and intrathoracic involvement are made possible. Details of the procedure with illustrations are described.- - - - - - - - - - ranking = 19.512647511934keywords = radiation-induced (Clic here for more details about this article) |
7/10. Myeloblastoma and acute myelogenous leukemia: presentation with a cervical neuropathy and complete response to chemotherapy.Myeloblastoma is an uncommon complication of acute and chronic myelogenous leukemia. This is report of a 25-year-old man who was seen with simultaneous acute myelogenous leukemia (AML) and a myeloblastoma involving right-sided C7 and C8 nerve roots. The myeloblastoma, visible as a left apical mass on chest radiogram, resolved completely after six days of intensive AML induction chemotherapy. The patient subsequently had a complete remission with total resolution of all neurologic deficits. He remains in remission now 2 1/2 years after initial diagnosis. An abnormal karyotype was present initially which became normal following chemotherapy. This case is an unusual example of myeloblastoma with peripheral nerve involvement. It illustrates that complete and durable resolution of these myeloblastic tumors can be achieved by intensive chemotherapy alone.- - - - - - - - - - ranking = 1.2keywords = leukemia (Clic here for more details about this article) |
8/10. Granulocytic sarcoma of the chest wall at site of Hickman catheter tract.Insertion of a Hickman central venous catheter before administration of induction chemotherapy is a common practice in treatment of patients with acute myeloblastic leukemia (AML). Granulocytic sarcoma associated with AML may be the initial clinical manifestation of newly diagnosed or relapsed AML, heralding systemic involvement by weeks to months. A case of granulocytic sarcoma of the chest wall occurring as subcutaneous nodules along a scar of a previous Hickman catheter tract in a 45 year old female patient with AML is described. The patient who was in first complete remission, developed granulocytic sarcoma simultaneously with complaints associated with leukemic CNS infiltration. This is the second case described of granulocytic sarcoma of the chest wall at the site of a Hickman catheter tract. The simultaneous CNS and chest wall manifestations raise the interesting question whether both sites behaved as sanctuaries for resistant leukemic cells, in this case.- - - - - - - - - - ranking = 0.2keywords = leukemia (Clic here for more details about this article) |
9/10. radiation-induced malignant mesenchymoma of the chest wall following treatment for breast cancer.21 years after radiotherapy for breast cancer, a 63-year-old woman developed a malignant mesenchymoma of the chest wall. The total irradiation dose was 132 Gy. The first clinical symptom of this second malignancy was a slight irregular calcification around the implanted silicon protheses observed in a conventional chest X-ray. radiation-induced sarcoma is a very rare complication of radiotherapy. In cases of chest wall calcification after radiation therapy further investigation should be carried out, because some patients with radiation-induced sarcoma could be saved, if an early diagnosis is reached.- - - - - - - - - - ranking = 19.512647511934keywords = radiation-induced (Clic here for more details about this article) |
10/10. Askin tumor and acute myeloid leukemia in a patient with constitutional partial Y disomy.We report the case of a young adult male carrying a constitutional unbalanced t(Y;13)(q11-12;p13) leading to a partial Y disomy, and presenting successively, in a 39-month interval, with an Askin tumor and a t(8;21) acute myeloid leukemia. The origin of the two neoplasias in this patient is discussed.- - - - - - - - - - ranking = 1keywords = leukemia (Clic here for more details about this article) |
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