Fluorescence in situ hybridization and surface markers of fine needle aspiration specimen confirm extramedullary myeloblastoma in a patient with chronic myeloid leukemia.
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.
Karthaus
M
M
Department of Haematology and Oncology, Hannover Medical School, Germany.
Meran
J G
JG
Wilkens
L
L
Soudah
B
B
Diedrich
H
H
Krauter
J
J
Ganser
A
A
Heil
G
G
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
D000954:Antigens, Surface; D014408:Biomarkers, Tumor