Cytogenetic evidence of metastatic myxoid liposarcoma and therapy-related myelodysplastic syndrome in a bone marrow biopsy.
Myxoid liposarcoma exhibits a peculiar clinical behavior, with a tendency to spread to serosal membranes, distant soft tissues, and bones, even in the absence of lung metastases. Therapy-related hematological neoplasms are well-known side effects of cytotoxic chemotherapy. We describe an exceptional case of metastatic myxoid liposarcoma of the spine associated with therapy-related refractory anemia with excess of blasts in a 37-year-old woman who underwent multi-agent chemotherapy for a myxoid liposarcoma of the left thigh. Microscopic examination of the bone marrow biopsy revealed dysplastic features, with abnormal localization of immature precursors and micromegakaryocytes, and islands of undifferentiated oval small/medium-size cells, suggestive of acute myeloid leukemia arising in the setting of a myelodysplastic syndrome. Immunohistochemistry was not discriminant. Cytogenetic analyses of bone marrow aspirate disclosed the presence of 2 different rearrangements, subsequently confirmed by fluorescent in situ hybridization and was crucial in making the correct diagnosis.
Department of Pathology, General Hospital, 31100 Treviso, Italy.
Sabrina
S
Rossi
Fabio
F
Canal
Stefano
S
Licci
Lucia
L
Zanatta
Licia
L
Laurino
Michele
M
Gottardi
Filippo
F
Gherlinzoni
Angelo Paolo
AP
Dei Tos
D000328:Adult; D000753:Anemia, Refractory / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001854:Bone Marrow Cells / Q000473:pathology; D002880:Chromosomes, Human, Pair 11; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000473:pathology; D018208:Liposarcoma, Myxoid / Q000473:pathology* / Q000556:secondary; D009190:Myelodysplastic Syndromes / Q000473:pathology*; D016609:Neoplasms, Second Primary / Q000473:pathology*; D012983:Soft Tissue Neoplasms / Q000473:pathology; D013848:Thigh / Q000473:pathology