4. Hrvatski kongres kliniËke citologije 4th Croatian Congress ... - Penta

4. Hrvatski kongres kliniËke citologije / 1. Hrvatski simpozij analitiËke citologije / 2. Hrvatski simpozij citotehnologije
MYELOID SARCOMA OF THE SKIN
Ilić I1 , Dotlić S1 , Gjadrov K1 , Sučić M1 , Bašić-Kinda S2 , Labar B2 44
Klinička citologija - Plenarna i pozvana predavanja
1 Zagreb University Clinical Hospital Center and School of Medicine, Clinical
Department of Pathology and Cytology, Zagreb, Croatia
2 3 Zagreb University Clinical Hospital Center and School of Medicine Department of
Hematology, Zagreb, Croatia
Background. Myeloid sarcoma (MS) is a solid tumor found at any site other than the bone
marrow, composed of myeloid blasts that may show different degrees of maturation.
Infiltrates of myeloid cells found in any site in the patient with leukemia are not classified
as MS. Case. We present the case of a 75-year old man with a nodular tumor on his
right calf. The tumor was grayish, measuring 1,8 cm in its largest diameter. Histologically,
the dermis was diffusely infiltrated by large tumor cells. Immunohistochemistry
showed that the tumor cells were positive for myeloperoxidase and myeloblasts were
positive for CD34. The cells were mostly myeloblasts but there were also myeloid cells
in different stages of maturation. The patient’s medical history revealed that he has
been previously treated for a chronic myeloid leukemia (CML) and then for transition
between accelerated phase and blast phase. So this case represents a disease progression
of CML presented with myeloid sarcoma. Conclusion. Clinical presentation of acute
leukemia as myeloid sarcoma of the skin is not rare, but always represents a diagnostic
challenge. The differential diagnoses of MS include lymphoma and histiocytic sarcoma,
both of which are excluded by the use of immunohistochemistry. To differentiate MS
from AML or CML infiltrates the clinical data must be provided because morphology and
immunohistochemistry are not sufficient.
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