Myeloid sarcoma involving the breast [Mijeloidni sarkom dojke]

Jelić-Puškarić, Biljana and Ostojić-Kolonić, Slobodanka and Planinc-Peraica, Ana and Obad-Kovačević, Dragica and Kardum-Skelin, Ika and Jakšić, Branimir (2010) Myeloid sarcoma involving the breast [Mijeloidni sarkom dojke]. Collegium Antropologicum, 34 (2). pp. 641-644. ISSN 0350-6134

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Abstract

Myeloid sarcoma is a tumor mass with extramedullary growth pattern, composed of myeloblasts or immature myeloid cells. The development of myeloid sarcoma may precede or concur with acute or chronic myeloid leukemia (AML or CML) or other myeloproliferative diseases or myelodysplastic syndromes (MDS). Isolated myeloid sarcoma of the breast is very rare. A case is presented of a 25-year-old, previously healthy woman that presented to our department for a palpable node, 5 x 2 cm in size, in the upper medial quadrant of her left breast. Fine needle aspiration (FNA) produced a sample consisting of medium sized blasts. Additional work-up revealed anemia, thrombocytopenia and leukocytosis, along with atypical blasts detected in peripheral blood and bone marrow smear. Based on the morphology, cytochemical characteristics and immature cell immunophenotype, it was considered a case of acute myeloid leukemia without maturation. In spite of intensive chemotherapy, the patient died within a year of diagnosis. In cases of isolated breast myeloid sarcoma, the diagnosis can be missed if the possibility of myeloid sarcoma is not remembered on differential diagnosis of a breast neoplasm.

Abstract in Croatian

Mijeloidni sarkom je ekstramedularna tumorska masa građena od mijeloblasta ili nezrelih mijeloičnih stanica. Može predhoditi ili se javiti istovremeno s akutnom ili kroničnom mijeloičnom leukemijom ili drugim tipovina mijeloproliferativnih bolesti ili mijelodisplastičnih sindroma. Izolirani mijeloidni sarkom dojke javlja se vrlo rijetko. Prikazujemo slučaj dvadesetpetogodišnje, do tada zdrave žene koja se javlja na kliniku radi palpabilnog čvora, veličine 5x2 cm u području gornjeg medijalnog kvadranta lijeve dojke. Citološkom punkcijom čvora tankom iglom dobije se uzorak srednje velikih blasta. U laboratorijskim nalazima nađe se anemija, trombocitopenija i leukocitoza, uz prisutne atipične blaste u razmazu periferne krvi i punktatu koštane srži. Obzirom na morfologiju, citokemijska obilježja i imunofenotip nezrelih stanica zaključeno je da se radi o akutnoj mijeločnoj leukemiji bez sazrijevanja. Unatoč intezivnoj kemoterapiji pacijentica umire unutar godinu dana od postavljnja dijagnoze. U slučaju izoliranog mijeloidnog srkoma dojke može se previdjeti točna dijagnoza ako se u diferencijalnoj dijagnozi tumora dojke ne razmišlja o mijeloidnom sarkomu.

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