Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023467 (acute myeloid leukemia)
 35,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An unusual case of granulocytic sarcoma with a large retro-orbital tumor mass is described. The tumor had an uncommon cytomorphology and ultrastructure that mimicked a signet ring cell lymphoma. It was negative by chloroacetate esterase (CAE) stain. The patient was treated successfully with CHOP-regimen polychemotherapy and irradiation. Seventeen months after the initial diagnosis of malignant lymphoma, acute myeloid leukemia developed. Additional immunohistochemistry, including an immunoperoxidase staining for lysozyme, clearly demonstrated the early myeloid nature of the original tumor. This case emphasizes the importance of staining for lysozyme and other myeloid markers in addition to CAE staining in cases that demonstrate unusual morphological features.
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PMID:Granulocytic sarcoma (chloroma). Presentation of an unusual case. 195 Nov 90

A 20-year-old male developed both coccygeal and leg pain and followed by rectocystic disturbance. Disc herniation between L5 and S was suspected and laminectomy was performed. At surgery, an easily curretable tumor occupied the epidural space from L5 to the end of the sacrum. In part, the tumor spread out of the vertebral canal and invaded the surrounding muscle tissue. This muscle tissue and part of the lamina were checked histologically. Initial blood analysis revealed 5% blast-like cells, but failed to confirm them as leukemic cells. Histologically, the tumor cells had round or oval nuclei with large nucleoli and scanty cytoplasm without granulocytic differentiation. Malignant lymphoma or Ewing's sarcoma was initially suspected, but the definite diagnosis was uncertain. Immunohistochemical staining with the PAP method and enzyme histochemistry revealed that the tumor cells were positive for lysozyme and naphthol ASD chloracetate esterase. Thus, granulocytic sarcoma was finally diagnosed. Electron microscopic findings supported this diagnosis. Subsequent karyotyping of bone marrow cells revealed 8; 21 translocation, thus the final diagnosis of this patient was myelodysplastic syndrome, refractory anemia with excess blast cells in transformation or acute myelogenous leukemia, M2, by the FAB classification.
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PMID:A case of epidural granulocytic sarcoma preceding acute leukemia. 209 94

We report a case history of a woman of 66 years of age who had a granulocytic sarcoma of the cervix which presented as metrorrhagia and which at first was thought to be an anaplastic cancer. The poor general state of the patient made it impossible to start any anti-leukaemic treatment and the patient died two months after the diagnosis was made. A review of the literature shows that 62 cases of granulocytic sarcoma have been reported of which 22 were in the breast, 19 in the ovary, 13 in the cervix or the uterus, 6 in the vagina and 2 in the vulva. The cells seem to invade the blood and the bone marrow in all occasions by the time of diagnosis or at the most a few weeks later and cases of granulocytic solitary sarcoma are very rare. It blood has not been attacked it is difficult to make a histological diagnosis unless immunological marking and Giemsa staining is carried out together with Leder's reaction. The treatment should be similar to those used for acute myeloid leukaemia.
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PMID:[Gynecologic and breast granulocytic sarcomas. Review of the literature. Apropos of a case in the cervix uteri]. 227 68

The fine-needle aspiration (FNA) cytology of two cases of granulocytic sarcoma involving the breast is reported along with the FNA cytology of one case of myeloid metaplasia (extramedullary hematopoiesis) involving an axillary lymph node. Two patients had known myeloproliferative disorders, while granulocytic sarcoma of the breast was the initial presentation of an unsuspected acute granulocytic leukemia in the other patient. Diff-Quik-stained preparations aided in the diagnosis of all three cases. Immunoperoxidase stains for factor VIII-related antigen helped confirm the megakaryocytic differentiation of the cells in the FNA cytology of myeloid metaplasia. Electron microscopic (EM) examination performed on the aspirated material also showed megakaryocytic differentiation of the bizarre cells. FNA cytology can make a specific diagnosis of granulocytic sarcoma and myeloid metaplasia. The workup of these unusual extramedullary myeloproliferative masses was aided when immunocytochemistry and EM were performed on the aspirated material.
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PMID:Fine-needle aspiration cytology of granulocytic sarcoma and myeloid metaplasia. 233 34

Mitoxantrone is a substituted anthraquinone with considerable activity against human acute leukemia. The authors' goal was to treat patients with continuous infusion mitoxantrone in order to maintain cytotoxic steady state levels with acceptable toxicity and to assess the results. Daily mitoxantrone levels showed a mean steady state plasma level of 16.8 +/- 1.4 ng/ml (range, 9.1-25.1) with a systemic clearance of 519 +/- 47 ml/minute/m2. No drug accumulation occurred. Mitoxantrone was undetectable 24 hours postinfusion. All patients, including two patients with chronic myelogenous leukemia in blast phase, had greater than 90% reduction in leukemia cell mass (marrow cellularity X percent leukemia cells) by day 6. However, six patients received 3 days of etoposide at that point because of residual acute nonlymphocytic leukemia (ANLL). Overall four patients (36%) had a complete remission; one additional patient had a bone marrow remission but also had a persistent granulocytic sarcoma. Toxicities included severe but tolerable myelosuppression, mucositis, and hepatic dysfunction. There was no correlation between mitoxantrone levels, toxicity, or clinical response. Continuous infusion produces cytotoxic plasma mitoxantrone levels and rapid clearing of ANLL from bone marrow. Further dose escalation may be possible.
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PMID:Continuous infusion mitoxantrone in relapsed acute nonlymphocytic leukemia. 234 Apr 63

Two cases of patients with prostatic granulocytic sarcoma in whom urinary obstruction occurred are presented. The diagnosis was made by tissue examination with hematoxylin and eosin and specific esterase stains. One patient had a myelodysplastic syndrome and the other patient had acute myeloblastic leukemia. In both cases the diagnosis of prostatic granulocytic sarcoma was unexpected. Granulocytic sarcomas should be considered in the differential diagnosis of urinary obstruction in patients with myeloproliferative or myelodysplastic syndromes.
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PMID:Granulocytic sarcoma of the prostate. Two cases causing urinary obstruction. 243 55

A 36-year-old woman presented with obstructive jaundice, found at laparotomy to be due to a granulocytic sarcoma in the head of the pancreas. Six months later she developed lymphadenopathy in the left supraclavicular fossa. In spite of chemotherapy containing cytarabine and vincristine, she developed acute myeloid leukaemia (French-American-British [FAB] type M4) 16 months after the onset of her illness.
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PMID:Obstructive jaundice. An unusual presentation of granulocytic sarcoma. 243 27

It is well known that MPSV induces myeloproliferative syndrome (MPS) in mice. Intravenous one shot inoculation of myeloproliferative sarcoma virus (MPSV) with Friend murine leukemia virus (F-MuLV) as a helper in newborn Jar-2 rats (on the second neonatal day) yielded hematopoietic malignancies in all the treated rats (25/25 rats) after 2 weeks' latency. MPS appeared from the 14th day in 14 rats. In the midst of the myeloproliferative field of the spleen and bone marrow, myeloblastic or myeloblastic-erythroblastic foci were observed. From 19th day, acute myeloblastic leukemia occurred in 3 rats and erythroleukemia in 8 rats. MPSV induced first MPS which remained as such or later developed into acute leukemia. Myelofibrosis as seen in mice was not observed. In addition, hemangiosarcoma of the brain, spinal cord and spleen appeared in 15 rats from the 24th day, and were often multiple. MPSV can yield the tumor only in newborn rats, and target cells of MPSV are not only hematopoietic cells but also endothelial cells of the brain, spinal cord and occasionally spleen.
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PMID:Histopathologic studies on myeloproliferative sarcoma virus (MPSV) induced leukemias and hemangiosarcoma in Jar-2 rats. 245 78

While he was being treated for Waldenstrom's macroglobulinemia, a 75-year-old man developed an enlarging forearm skin nodule. On biopsy, the lesion appeared to be a malignant lymphoma. The tumor cells were negative for immunoglobulins but positive for lysozyme and alpha-1-antitrypsin. Therefore, the lesion was diagnosed as histiocytic lymphoma. Nine months later, an ipsilateral axillary lymph node biopsy revealed a small focus of tumor identical to that of the skin lesion. Three months after the lymph node biopsy, the patient developed acute myeloid leukemia. A reevaluation of the electron micrographs of the skin and lymph node lesion showed primary lysosomal granules within the tumor cell cytoplasm consistent with a diagnosis of leukemic infiltrates (granulocytic sarcoma); additionally, the naphthol AS-D chloracetate esterase activity of the skin lesion was positive, supporting the diagnosis of granulocytic sarcoma. This report shows that if not suspected, granulocytic sarcoma is difficult to diagnose in nonleukemia patients.
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PMID:Granulocytic sarcoma presenting as a solitary nodule of skin in a patient with Waldenstrom's macroglobulinemia. An immunohistochemical and electron-microscopic study. 236 Sep 34

Thirty-three patients presenting with orbito-ocular granulocytic sarcoma (OOGS) and acute myelomonocytic leukemia (AMML) were diagnosed in Turkish children from 1963 to 1983. OOGS, characterized by exophthalmos, chemosis and orbital masses, was observed in 33 (27.2%) of 121 AML patients compared with 41 children of AMML without ophthalmic tumors during the same period. Eye tumor and bone marrow aspirates were also studied under light and electron microscopies. The comparison of the hematological parameters did not indicate any statistical difference between the groups. Despite similar chemotherapy regimens administered to all patients, the mean survival time was 8.7 months in the OOGS group, which is significantly shorter compared to those without OOGS (28.6 months) (p less than 0.01). These cases may be classified as a "high risk" subgroup of childhood AMML.
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PMID:High risk subgroup of acute myelomonocytic leukemia (AMML) with orbito-ocular granulocytic sarcoma (OOGS) in Turkish children. Retrospective analysis of clinical, hematological, ultrastructural and therapeutical findings of thirty-three OOGS. 249 55


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