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Journal of Clinical Pathology 2005;58:325-327
© 2005 BMJ Publishing Group Ltd & Association of Clinical Pathologists


CASE REPORT

Massive myeloid sarcoma affecting the central nervous system, mediastinum, retroperitoneum, liver, and rectum associated with acute myeloblastic leukaemia: a case report

C R Best-Aguilera1, M Vazquez-Del Mercado2, J F Muñoz-Valle2, L Herrera-Zarate1, R E Navarro-Hernandez2, B T Martin-Marquez2, E Oregon-Romero2, S Ruiz-Quezada2, G M Bonilla2, A Lomeli-Guerrero1

1 Departmento de Hematologia, Hospital General de Occidente, SSJ, Zapopan, Jalisco, 45170 México
2 Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, 44290 Mexico

Correspondence to:
Dr C R Best-Aguilera
Av. Zoquipan, 1050 Zapopan Jal., México, 45175; bestvme{at}cencar.udg.mx
ABSTRACT
Myeloid sarcomas are extramedullary tumours with granulocytic precursors. When associated with acute myelogenous leukaemia (AML), these tumours usually affect no more than two different extramedullary regions. This report describes a myeloid sarcoma associated with AML with tumour formation at five anatomical sites. The patient was a 37 year old man admitted in September 1999 with a two month history of weight loss, symptoms of anaemia, rectal bleeding, and left facial nerve palsy. The anatomical sites affected were: the rectum, the right lobe of the liver, the mediastinum, the retroperitoneum, and the central nervous system. A bone marrow smear was compatible with AML M2. Flow cytometry showed that the peripheral blood was positive for CD4, CD11, CD13, CD14, CD33, CD45, and HLA-DR. A karyotypic study of the bone marrow revealed an 8;21 translocation. The presence of multiple solid tumours in AML is a rare event. Enhanced expression of cell adhesion molecules may be the reason why some patients develop myeloid sarcomas.


Abbreviations: AML, acute myelogenous leukaemia

Keywords: acute myelogenous leukaemia; myeloid sarcoma







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