title: Case Report: Myelodysplastic syndrome- associated myeloid sarcoma: an unusual clinical presentation of a rare disease.
abstract: Myeloid sarcoma results from the extramedullary homing and proliferation of immature myeloid precursors. We present the timeline, events and diagnostic pitfalls related to a 66 year-old male patient's case, admitted to the Hematology Clinic for pancytopenia, fever, weight loss and fatigue. The severe cytopenia and the few blasts observed in his blood smear indicated a bone marrow biopsy. The bone marrow showed hypercellularity and multilineage dysplasia with the presence of 15% myeloblasts. After the biopsy, he promptly developed paraplegia and nuclear magnetic resonance revealed an epidural tumour which was then resected.In the epidural tumour mass blast-like, round cells were observed with a complex immunophenotype, characterized by myeloperoxidase, CD117, CD15, CD99, leucocyte common antigen positivity and a high Ki-67 proliferation index. Considering the main differential diagnostic issues, the final diagnosis was stated as myelodysplastic syndrome-associated myeloid sarcoma. The prognosis was unfavourable, the bone marrow was quickly invaded by proliferating blast cells, and despite chemotherapy attempts, the patient died.
authors.affiliation: Deptartment of Pathology, University of Medicine and Pharmacy of Targu Mures, Targu-Mures, Romania.
authors.forename: Emoke
authors.initials: E
authors.lastname: Horvath
authors.affiliation: Hematology Clinic 1, Emergency Clinical Hospital,, University of Medicine and Pharmacy of Targu Mures, Targu-Mures, Romania.
authors.forename: Smaranda
authors.initials: S
authors.lastname: Demian
authors.affiliation: Deptartment of Pharmacy and Biochemistry, University of Medicine and Pharmacy of Targu Mures, Targu-Mures, Romania; , Laboratory of Medical Analysis, Clinical County Hospital Mures, Targu-Mures, Romania.
authors.forename: Elod
authors.initials: E
authors.lastname: Nagy
keywords: immunophenotype; myelodysplastic syndrome; myeloid blasts; myeloid sarcoma