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Refractory right ventricular failure due to granulocytic sarcoma.
1Division of Surgical Pathology, Veterans Administration Lakeside Medical Center, Chicago, Ill.
Archives of Pathology & Laboratory Medicine
|September 1, 1990
Summary
A rare case of granulocytic sarcoma (chloroma) caused fatal right ventricular failure in a patient with agnogenic myeloid metaplasia. This diffuse cardiac involvement by granulocytic sarcoma is unprecedented.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Agnogenic myeloid metaplasia is a myeloproliferative neoplasm.
- Granulocytic sarcoma, also known as chloroma, is a rare extramedullary tumor of myeloid blasts.
- Right ventricular failure is a serious cardiovascular condition.
Observation:
- A 72-year-old man with a history of agnogenic myeloid metaplasia developed refractory right ventricular failure.
- A biopsy revealed granulocytic sarcoma in the anterior abdominal wall.
- Autopsy showed disseminated granulocytic sarcoma extensively encasing the heart and great vessels.
Findings:
- This is the first reported case of granulocytic sarcoma diffusely involving the heart.
- The cardiac involvement led to massive encasement of the heart and great vessels.
- The extensive cardiac infiltration by granulocytic sarcoma caused fatal hemodynamic abnormalities and refractory right ventricular failure.
Implications:
- This case highlights a rare but fatal complication of agnogenic myeloid metaplasia.
- It underscores the importance of considering granulocytic sarcoma in patients with myeloid metaplasia presenting with cardiac symptoms.
- Further research may elucidate the mechanisms of cardiac infiltration by granulocytic sarcoma.