title: Fluorescence in situ hybridization and surface markers of fine needle aspiration specimen confirm extramedullary myeloblastoma in a patient with chronic myeloid leukemia.
abstract: We report on a patient with chronic myeloid leukemia (CML) with a rapidly growing left cervical tumor 5 months after the initial diagnosis of CML. This tumor was diagnosed as a very early manifestation of extramedullary myeloblastoma by a minimally invasive method. A fine needle aspirate (26-gauge needle) was obtained from the tumor. Morphological and cytochemical analysis of the aspirate revealed 19% undifferentiated blasts. The immunophenotype was suggestive of a myeloid differentiation of the blasts (CD33+). The CML origin of the blasts was confirmed by the detection of the bcr-abl gene rearrangement in the blasts by two-color fluorescence in situ hybridization (FISH). We conclude that fine needle aspiration in combination with immunophenotyping and FISH analysis of the aspirate is a minimally invasive and rapid diagnostic tool to confirm extramedullary manifestation in CML. To our knowledge, this is the first case of extramedullary myeloblastoma confirmed by this combined technique.
authors.affiliation: Department of Haematology and Oncology, Hannover Medical School, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Karthaus
authors.forename: J G
authors.initials: JG
authors.lastname: Meran
authors.forename: L
authors.initials: L
authors.lastname: Wilkens
authors.forename: B
authors.initials: B
authors.lastname: Soudah
authors.forename: H
authors.initials: H
authors.lastname: Diedrich
authors.forename: J
authors.initials: J
authors.lastname: Krauter
authors.forename: A
authors.initials: A
authors.lastname: Ganser
authors.forename: G
authors.initials: G
authors.lastname: Heil
mesh_terms: D000328:Adult; D000954:Antigens, Surface / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D001752:Blast Crisis / Q000378:metabolism / Q000473:pathology; D005260:Female; D016313:Genes, abl; D006411:Hematopoiesis, Extramedullary; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000378:metabolism / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000473:pathology
chemical_list: D000954:Antigens, Surface; D014408:Biomarkers, Tumor