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Chronic myeloid leukaemia with soft tissue mass formed by mature granulocytes
  1. Soichi Koto1,
  2. Yoshinobu Kanda2,
  3. Nobuhito Ohnou3 and
  4. Yoshinori Morita1
  1. 1Internal Medicine, Kagoshima Prefecture Oshima Hospital, Amami, Japan
  2. 2Division of Hematology, Jichi Medical University, Shimotsuke, Japan
  3. 3Department of Hematology, Kirishima Medical Center, Kirishima, Japan
  1. Correspondence to Dr Soichi Koto; dr.koto.060612{at}gmail.com

Abstract

Extramedullary lesions in patients with chronic myeloid leukaemia (CML) suggest progression to the blast phase because such lesions generally consist of immature granulocytes. We here report a case of an extramedullary mass formed by mature granulocytes during the chronic phase of CML. A 60-year-old woman who had discontinued treatment for CML with dasatinib of her own accord several years ago presented to our hospital with a complaint of right thigh pain. She had a mass on her right leg, which was located on her right thigh and was elastic, soft and fist-sized. Blood tests and the bone marrow findings were compatible with the chronic phase of CML, and a CT-guided needle biopsy showed an infiltrate containing numerous mature neutrophils and foam cells. The mass disappeared with dasatinib alone, without antibacterial agents or drainage.

Although the detailed pathogenesis of mass formation with mature granulocytes in the chronic phase of CML has not been elucidated, the clinical course of the current case highlights the importance of prompt biopsy, pathological examination and the early initiation of appropriate treatment.

  • Chronic Myeloid Leukemia
  • Haematology (drugs and medicines)
  • Dasatinib

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: SK, YK, NO and YM. The following authors gave final approval of the manuscript: SK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests YK received honoraria from Pfizer, Novartis Pharma and Bristol Myers Squibb.

  • Provenance and peer review Not commissioned; externally peer reviewed.