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Lymphoma

Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients

Leukemia volume 21, pages 340–350 (2007)Cite this article

Abstract

Myeloid sarcoma (MS) is a rare neoplasm whose knowledge is largely based on case reports and/or technically dated contributions. Ninety-two MSs in adulthood with clinical data available were evaluated both morphologically and immunohistochemically. Seventy-four cases were also studied by fluorescent in situ hybridization on tissue sections and/or conventional karyotyping on bone marrow or peripheral blood. Histologically, 50% of the tumors were of the blastic type, 43.5% either monoblastic or myelomonocytic and 6.5% corresponded to different histotypes. CD68/KP1 was the most commonly expressed marker (100%), followed by myeloperoxidase (83.6%), CD117 (80.4%), CD99 (54.3%), CD68/PG-M1 (51%), CD34 (43.4%), terminal-deoxy-nucleotidyl-transferase (31.5%), CD56 (13%), CD61/linker for activation of T cells (2.2%), CD30 (2.2%) and CD4 (1.1%). Foci of plasmacytoid monocyte differentiation were observed in intestinal cases carrying inv16. Chromosomal aberrations were detected in about 54% of cases: monosomy 7(10.8%), trisomy 8(10.4%) and mixed lineage leukemia-splitting (8.5%) were the commonest abnormalities, whereas t(8;21) was rare (2.2%). The behavior was dramatic irrespective of presentation, age, sex, phenotype and cytogenetics. Most if not all, long survivors received bone-marrow transplantation. The present report expands the spectrum of our knowledge showing that MS has frequent monoblastic/myelomonocytic differentiation, displays distinctive phenotypic profile, carries chromosomal aberrations other than t(8;21), and requires supra-maximal therapy.

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Acknowledgements

This work was supported by Italian Association for Cancer Research (AIRC, Milan), Italian Ministry of University and Research (MIUR, Rome), Fondazione Cassa di Risparmio in Bologna, Fondazione della Banca del Monte e Ravenna (Bologna) and BolognAIL (Bologna).

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Authors and Affiliations

  1. Institute of Hematology and Clinical Oncology ‘L. and A. Seràgnoli’, University of Bologna, Bologna, Italy

    S A Pileri, C Campidelli, F Bacci, M Piccioli, P P Piccaluga, C Agostinelli, P L Zinzani & M Baccarani

  2. Institute of Pathologic Anatomy, University of Perugia in Terni, Terni, Italy

    S Ascani

  3. Chair of Hematology, ‘La Sapienza’ University of Rome, Rome, Italy

    M C Cox

  4. Division of Pathologic Anatomy, S. Maria Nuova Hospital, Reggio Emilia, Italy

    S Asioli

  5. Institute of Pathology, University of Turin, Turin, Italy

    D Novero

  6. Division of Pathologic Anatomy, Casa Sollievo della Sofferenza Hospital, S Giovanni Rotondo, Italy

    M Bisceglia

  7. Institute of Pathologic Anatomy, Vita-Salute S. Raffaele University, Milan, Italy

    M Ponzoni

  8. Institute of Pathologic Anatomy, University of Bari, Bari, Italy

    A Gentile

  9. Division of Pathologic Anatomy, Infermi Hospital, Rimini, Italy

    P Rinaldi

  10. Institute of Pathologic Anatomy, University of Palermo, Palermo, Italy

    V Franco

  11. Division of Hematology, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy

    D Vincelli

  12. Institute of Dermatology, University of Bologna, Bologna, Italy

    A Pileri Jr

  13. Department of Pathology, San Camillo-Forlanini Hospital, Rome, Italy

    R Gasbarra

  14. Institute of Haematology, University of Perugia, Perugia, Italy

    B Falini

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  1. S A Pileri
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Pileri, S., Ascani, S., Cox, M. et al. Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients. Leukemia 21, 340–350 (2007). https://doi.org/10.1038/sj.leu.2404491

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