A Case of Extramedullary Blast Crisis of CML Presented as a Large Mediastinum Lump
LIN Zhi-mei
ZHU Huan-ling
RAO Jin
YIN Li
LI Shi-yun
Abstract：Objective To explore the diagnosis, differential diagnosis and therapy of extramedullary blast crisis of chronic myelogenous leukemia ( CML-EBC) . Methods A case of extramedullary blast crisis of CML presented as a large me-diastinum lump was reported and the related literature was reviewed. Results With diagnosis of chronic myelogenous leuke-mia for 3 years, this patient was readmitted for chest pain associated with dyspnea. The chest CT scan showed that there was a spindle soft tissue density by the thoracic and abdominal aorta. Bone marrow smear and fluid cytology confirmed chronic phase of the chronic myelogenous leukemia. Mediastinal lesions biopsy under thoracoscope, and immunohistochemistry fea-tures suggested malignant tumor infiltration from the lymphatic hematopoietic system. Chronic myelogenous leukaemia-extr-amedullary blast crisis from B lymphocytes was confirmed. After the treatment of imatinib, the patient condition was improved and was discharged from hospital. The patient continued to take the imatinib for maintenance treatment. Conclusion CML-EBC presented as a local lump tends to be misdiagnosed as CML with lymphoma if tumour cells expressing lymphocyte markers and the diagnosis relied on the fusion signals between BCR and ABL genes, which were identified in the biopsy specimens by FISH. Special attention to the differential diagnosis should be paid. Combined therapy of tyrosine kinase inhibitors and chemo-therapy, radiotherapy or stem cell transplantation is an optional choice to in the treatment CML-EBC.
Keywords：Leukemiamyeloidblast crisisMisdiagnosisLymphomaFluorescence in situ hybridization
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 28-31 )