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Metastasis02:30

Metastasis

Metastasis is the spread of cancer cells from the original site to distant locations in the body. Cancer cells can spread via blood vessels (hematogenous) as well as lymph vessels in the body.
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...

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Identifying, Diagnosing, and Grading Malignant Peripheral Nerve Sheath Tumors in Genetically Engineered Mouse Models
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Multiple granulocytic sarcomas in essential thrombocythemia.

Yasuhiro Tanaka1, Yuya Nagai, Minako Mori

  • 1Department of Hematology and Clinical Immunology, Kobe City General Hospital, Kobe, Japan.

International Journal of Hematology
|December 26, 2006
PubMed
Summary

This case highlights a rare occurrence of granulocytic sarcoma in essential thrombocythemia, presenting multiple lesions and fractures without overt leukemia transformation. It underscores the importance of vigilance for extramedullary manifestations in myeloproliferative neoplasms.

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Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Essential thrombocythemia (ET) is a myeloproliferative neoplasm characterized by elevated platelet counts.
  • Long-term management of ET involves various cytoreductive agents.
  • Transformation to acute myeloid leukemia or myelofibrosis is a known complication.

Observation:

  • A 59-year-old woman with ET developed hepatosplenomegaly, fever, and weight loss.
  • Bone marrow biopsy revealed myelofibrosis, and an abnormal karyotype (der(1;13)) emerged.
  • A granulocytic sarcoma was diagnosed in the femoral head, followed by multiple bone lesions and a pathologic fracture.

Findings:

  • The patient presented with extramedullary granulocytic sarcoma, a rare complication of ET.
  • Karyotypic abnormalities, including a 7q22 deletion, were identified.
  • The patient experienced multiple bone lesions and a pathologic fracture without evidence of overt leukemia transformation.

Implications:

  • This case represents a potential first report of essential thrombocythemia with multiple granulocytic sarcoma lesions and pathologic fracture without overt leukemia.
  • It emphasizes the need to consider extramedullary disease, such as granulocytic sarcoma, in the differential diagnosis of unexplained symptoms in ET patients.
  • Further research into the mechanisms and management of extramedullary manifestations in ET is warranted.