title: Chronic myelogenous leukemia presenting in blast phase with nodal, bilineal myeloid sarcoma and T-lymphoblastic lymphoma in a child.
abstract: A 14-year-old boy presented with chronic myelogenous leukemia (CML) in blast phase with segregated extramedullary (nodal) myeloid sarcoma and T-lymphoblastic lymphoma. Immunohistochemical stains performed on the lymphadenectomy sample demonstrated T lymphoblasts in the lymph nodes and myeloblasts in the adjacent soft tissue. Fluorescence in situ hybridization performed on paraffin sections confirmed that both T-lymphoblast and myeloblast populations were positive for the t(9;22) BCR/ABL1 translocation. Subsequent flow cytometry analysis of the bone marrow showed expanded populations of abnormal myeloblasts and T lymphoblasts diagnostic of blast phase CML. To the best of our knowledge, bilineal blast phase of CML with segregated extramedullary T lymphoblasts and myeloblasts has not been reported.
authors.affiliation: Department of Laboratory Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Xueyan
authors.initials: X
authors.lastname: Chen
authors.forename: Joe C
authors.initials: JC
authors.lastname: Rutledge
authors.forename: David
authors.initials: D
authors.lastname: Wu
authors.forename: Min
authors.initials: M
authors.lastname: Fang
authors.forename: Kent E
authors.initials: KE
authors.lastname: Opheim
authors.forename: Min
authors.initials: M
authors.lastname: Xu
mesh_terms: D000293:Adolescent; D001752:Blast Crisis / Q000235:genetics / Q000473:pathology*; D005434:Flow Cytometry; D016044:Fusion Proteins, bcr-abl / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D017404:In Situ Hybridization, Fluorescence; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000235:genetics / Q000473:pathology*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000235:genetics / Q000473:pathology*; D054218:Precursor T-Cell Lymphoblastic Leukemia-Lymphoma / Q000235:genetics / Q000473:pathology*; D023981:Sarcoma, Myeloid / Q000235:genetics / Q000473:pathology*
chemical_list: D016044:Fusion Proteins, bcr-abl