Myeloid sarcoma occurring concurrently with drug-induced gingival enlargement.
BACKGROUND
Myeloid sarcoma is an extramedullary malignancy of myeloblasts. An unusual case of myeloid sarcoma presenting in the gingiva and affected by drug-induced gingival enlargement is presented.


METHODS
A 63-year-old male taking amlodipine for his hypertension presented with a 3-week gingival enlargement. Although the obvious clinical impression was that of drug-induced gingival enlargement, an incisional biopsy was performed to corroborate chemical enlargement while ruling out diseases such as lymphoma and leukemia.


RESULTS
Microscopic examination of the thickened gingiva revealed surface stratified squamous epithelium having needle-like rete pegs characteristic of drug-induced gingival enlargement. Beneath the surface epithelium, the fibrous tissue was virtually replaced by a dense infiltrate of malignant cells. Immunohistochemical studies were performed with CD117 and myeloperoxidase identifying the malignant cell population as myeloblasts, leading to a diagnosis of myeloid sarcoma.


CONCLUSIONS
Myeloid sarcoma and hematopoietic malignancies must be included in a differential diagnosis of gingival enlargement until the definitive diagnosis is reached by histologic/laboratory examination.
Yoon
Angela J
AJ
Department of Pathology, Division of Oral Pathology, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032, USA.
Pulse
Carla
C
Cohen
Lori D
LD
Lew
Timothy A
TA
Zegarelli
David J
DJ
D017311:Amlodipine / Q000009:adverse effects*; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001706:Biopsy; D003937:Diagnosis, Differential; D004848:Epithelium / Q000473:pathology; D005887:Gingival Neoplasms / Q000150:complications / Q000175:diagnosis*; D019214:Gingival Overgrowth / Q000139:chemically induced / Q000175:diagnosis*; D006801:Humans; D007951:Leukemia, Myeloid / Q000150:complications / Q000175:diagnosis*; D017493:Leukocyte Common Antigens / Q000032:analysis; D008297:Male; D008875:Middle Aged; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis
D000959:Antihypertensive Agents; D017311:Amlodipine; D019009:Proto-Oncogene Proteins c-kit; D017493:Leukocyte Common Antigens