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Published on: March 26, 2018
Aleukemic bcr-abl positive granulocytic sarcoma.
Jew-Win Kuan1, Rajadurai Pathmanathan, Kian-Meng Chang
1Hematology Department, Ampang Hospital, Jalan Mewah Utara, Pandan Mewah, 68000 Ampang, Selangor, Malaysia. kuanjewwin@hotmail.com
Leukemia Research
|February 14, 2009
Summary
Primary granulocytic sarcoma (GS) can present without chronic myeloid leukemia (CML). Molecular testing revealed a bcr-abl translocation in the tumor, suggesting CML may manifest solely as extramedullary disease, treatable with tyrosine kinase inhibitors.
Area of Science:
- Hematology
- Oncology
- Molecular Pathology
Background:
- Granulocytic sarcoma (GS) is a myeloid tumor occurring extramedullary or with myeloid disorders.
- Sophisticated molecular diagnostics (e.g., bcr-abl, PML-RARA) challenge the classification of 'primary' GS.
- Distinguishing primary GS from CML with extramedullary involvement is clinically significant.
Observation:
- A case of primary granulocytic sarcoma (GS) is presented.
- The tumor mass demonstrated a bcr-abl translocation via fluorescent in situ hybridization.
- No evidence of chronic myeloid leukemia (CML) was found in bone marrow or peripheral blood.
Findings:
- The bcr-abl translocation in the extramedullary tumor suggests a potential molecular link to CML.
- This case indicates that CML might present exclusively as extramedullary disease.
Implications:
- Reclassifies 'primary' GS cases with molecular evidence of myeloid malignancy.
- Highlights the potential for CML to manifest solely as granulocytic sarcoma.
- Suggests tyrosine kinase inhibitors as a potential therapeutic strategy for such cases.
