Abstract
Four patients in whom a diagnosis of acute monocytic leukaemia (M5) was subsequently made presented with extramedullary disease clinically resembling lymphoma. In all patients histological sections were initially misinterpreted as showing malignant lymphoma or anaplastic carcinoma. The diagnosis of M5 leukaemia was subsequently made on the basis of morphological and cytochemical studies of peripheral blood and bone marrow. The histological diagnosis of the soft tissue lesions of M5 leukaemia (monocytic sarcoma) is difficult, although features such as abundant cytoplasm and the presence of some reniform nuclei are helpful. If there is no peripheral blood or bone marrow involvement and only fixed paraffin-embedded tissues are available, demonstration of lysozyme by an immunoperoxidase technique may confirm the diagnosis but results are not invariably positive. An early diagnosis of M5 leukaemia has therapeutic implications since the disease evolves through a progressive leukaemia phase and systemic therapy is essential.
Full text
PDF
Images in this article
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Bennett J. M., Catovsky D., Daniel M. T., Flandrin G., Galton D. A., Gralnick H. R., Sultan C. Proposals for the classification of the acute leukaemias. French-American-British (FAB) co-operative group. Br J Haematol. 1976 Aug;33(4):451–458. doi: 10.1111/j.1365-2141.1976.tb03563.x. [DOI] [PubMed] [Google Scholar]
- Catovsky D., de Salvo Cardullo L., O'Brien M., Morilla R., Costello C., Galton D., Ganeshaguru K., Hoffbrand V. Cytochemical markers of differentiation in acute leukemia. Cancer Res. 1981 Nov;41(11 Pt 2):4824–4832. [PubMed] [Google Scholar]
- Chilosi M., Pizzolo G., Menestrina F., Iannucci A. M., Bonetti F., Fiore-Donati L. Enzyme histochemistry on normal and pathologic paraffin-embedded lymphoid tissues. Am J Clin Pathol. 1981 Dec;76(6):729–736. doi: 10.1093/ajcp/76.6.729. [DOI] [PubMed] [Google Scholar]
- Howard D. R., Batsakis J. G. Peanut agglutinin: a new marker for tissue histiocytes. Am J Clin Pathol. 1982 Apr;77(4):401–408. doi: 10.1093/ajcp/77.4.401. [DOI] [PubMed] [Google Scholar]
- Isaacson P., Wright D. H., Judd M. A., Mepham B. L. Primary gastrointestinal lymphomas: a classification of 66 cases. Cancer. 1979 May;43(5):1805–1809. doi: 10.1002/1097-0142(197905)43:5<1805::aid-cncr2820430534>3.0.co;2-6. [DOI] [PubMed] [Google Scholar]
- Mason D. Y., Taylor C. R. The distribution of muramidase (lysozyme) in human tissues. J Clin Pathol. 1975 Feb;28(2):124–132. doi: 10.1136/jcp.28.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Neiman R. S., Barcos M., Berard C., Bonner H., Mann R., Rydell R. E., Bennett J. M. Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer. 1981 Sep 15;48(6):1426–1437. doi: 10.1002/1097-0142(19810915)48:6<1426::aid-cncr2820480626>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
- O'Brien M., Catovsky D., Costello C. Ultrastructural cytochemistry of leukaemic cells: characterization of the early small granules of monoblasts. Br J Haematol. 1980 Jun;45(2):201–208. doi: 10.1111/j.1365-2141.1980.tb07139.x. [DOI] [PubMed] [Google Scholar]
- Peterson L., Dehner L. P., Brunning R. D. Extramedullary masses as presenting features of acute monoblastic leukemia. Am J Clin Pathol. 1981 Feb;75(2):140–148. doi: 10.1093/ajcp/75.2.140. [DOI] [PubMed] [Google Scholar]
- Straus D. J., Mertelsmann R., Koziner B., McKenzie S., de Harven E., Arlin Z. A., Kempin S., Broxmeyer H., Moore M. A., Menendez-Botet C. J. The acute monocytic leukemias: multidisciplinary studies in 45 patients. Medicine (Baltimore) 1980 Nov;59(6):409–425. doi: 10.1097/00005792-198011000-00002. [DOI] [PubMed] [Google Scholar]