title: Lymphnode localization of extramedullary myeloid cell tumor in myelodysplastic syndrome: report of one case diagnosed by fine-needle cytology.
abstract: Trilineage extramedullary myeloid tumor (EMT) is an uncommon medical condition mostly diagnosed in patients affected by acute or chronic myeloid leukemia or, more rarely, by a myelodysplastic syndrome, among which the most frequent is refractory anemia with excess of blasts in transformation (RAEB-t). The prognostic significance of EMT is still unclear, although the appearance of trilineage EMT is often considered to affect the outcome adversely. A 70-year-old lady with previous history of intestinal resection for colonic adenocarcinoma in 1995 and subsequently treated with 5-fuorouracyl developed a refractory anemia with excess of blasts (RAEB) in 1998. During the follow-up, a progression to RAEB-t was recorded. During chemotherapy for this condition, slight enlargement of left supraclavicular and right submandibular nodes was noticed. Fine-needle biopsy was performed with ancillary studies. A diagnosis of trilineage extramedullary myeloid tumor was reached. The patient was treated with low doses of chemotherapy with a good response lasting 12 months. The peculiar cytologic picture of this condition when corroborated by ancillary studies (immunocytochemistry and flow cytometry) is diagnostic of this rare condition. Furthermore, the extramedullary myeloid tumor in this case did not significantly affect the response to the chemotherapy of RAEB-t.
authors.affiliation: Dipartimento di Scienze Biomorfologiche e Funzionali, Sezione di Anatomia Patologica e Citopatologia, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Fulciniti
authors.forename: Pio
authors.initials: P
authors.lastname: Zeppa
authors.forename: Gilda
authors.initials: G
authors.lastname: Marino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Martinelli
authors.forename: Rosanna
authors.initials: R
authors.lastname: Ciancia
authors.forename: Luigi
authors.initials: L
authors.lastname: Del Vecchio
authors.forename: Bruno
authors.initials: B
authors.lastname: Rotoli
authors.forename: Lucio
authors.initials: L
authors.lastname: Palombini
mesh_terms: D000368:Aged; D000754:Anemia, Refractory, with Excess of Blasts / Q000150:complications / Q000188:drug therapy / Q000473:pathology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000379:methods*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007951:Leukemia, Myeloid / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D008198:Lymph Nodes / Q000473:pathology*; D016609:Neoplasms, Second Primary; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D016896:Treatment Outcome