engleski

Myeloid sarcoma of the skin

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 and myeloproliferative disease 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.

myeloid sarcoma ; skin ; leukemia

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