Myeloid sarcoma of the heart-A clinicopathological correlation
Kristijan Skok1, Martin Zacharias1, Nicolas Verheyen2
1Diagnostic and Research Institute of Pathology, Medical University of Graz, Stiftingtalstraße 6, 8010, Graz, Austria.
Insights
A rare case of cardiac myeloid sarcoma is presented in a patient with acute myeloid leukemia and a history of stem cell transplantation. This infiltrative cardiomyopathy led to fatal heart failure.
Area of Science:
- Cardiology
- Hematology
- Oncology
Background:
- Cardiac involvement in acute myeloid leukemia (AML) is uncommon.
- Myeloid sarcoma, an extramedullary tumor of myeloid blasts, can rarely infiltrate the heart.
- Infiltrative cardiomyopathy can present as heart failure with preserved ejection fraction.
Purpose of the Study:
- To report a rare case of primary cardiac myeloid sarcoma.
- To highlight the diagnostic challenges and clinical presentation of cardiac myeloid sarcoma.
- To discuss the implications for patients with a history of AML and stem cell transplantation.
Main Methods:
- Case report presentation.
- Review of patient history, clinical presentation, and diagnostic findings.
- Echocardiography and autopsy findings are detailed.
Main Results:
- A 63-year-old woman with AML and stem cell transplant history presented with acute heart failure.
- Echocardiography showed severe ventricular hypertrophy and elevated filling pressures, suggestive of infiltrative cardiomyopathy.
- Autopsy revealed an enlarged heart with a characteristic fish-flesh appearance, confirming cardiac myeloid sarcoma.
Conclusions:
- Cardiac myeloid sarcoma is a rare but critical complication in AML patients.
- Early recognition and diagnosis are crucial for management, though prognosis remains poor.
- This case underscores the importance of considering extramedullary myeloid disease in the heart.
Abstract:
A 63-year-old woman with a history of acute myeloid leukemia followed by stem cell transplantation presented with acute heart failure. Transthoracic echocardiography revealed a preserved left ventricular ejection fraction with severe ventricular hypertrophy and signs of elevated filling pressures indicating infiltrative cardiomyopathy. She died from cardiac arrest due to cardiogenic shock. The autopsy revealed an enlarged heart with a fish-flesh appearance. Here, we describe a rare case of a myeloid sarcoma of the heart.
