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      Primary bronchial myeloid sarcoma mimicking bronchogenic carcinoma: a case report

      case-report

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          Abstract

          Background

          Myeloid sarcoma (MS) rarely involves the bronchus, and primary bronchial MS has almost never been reported in mainland China.

          Case presentation

          A 65-year-old female patient was admitted with a 3-month history of cough. She was initially diagnosed with bronchogenic carcinoma according to chest computed tomography (CT). However, after a biopsy was taken from the endobronchial lesion by bronchoscopy and further immunohistochemical analysis was performed, the diagnosis of MS was made. Because her bone marrow was normal and she had no history of haematologic diseases, we further considered the diagnosis of primary bronchial MS. The patient received chemotherapy with HAG regimens, and the original mass completely resolved, as confirmed by chest CT scan after 3 cycles of treatment. Meanwhile, no abnormalities were found on re-examination via bronchoscopy.

          Conclusions

          MS should be considered in the differential diagnosis in the presence of a suspicious pulmonary mass. Immunohistochemical analysis is necessary to confirm the diagnosis. Chemotherapy can lengthen the survival time for patients.

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          Most cited references6

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          Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases.

          Granulocytic sarcoma is an uncommon tumor composed of granulocytic precursor cells. Because it occurs in a variety of clinical settings and because the tumor cells are primitive it is frequently unrecognized during life. This presentation details the authors' experience with 61 biopsy-proven granulocytic sarcomas. The patient age range was from 2 to 81 years (mean 48 years). In eight patients the tumors were multiple. Most common sites of involvement were bone, periosteum, soft tissue, lymph node and skin. Twenty-two tumors occurred in 15 patients with no known disease, 26 occurred in 24 patients with a known myeloproliferative disorder, and 13 occurred in 11 patients with proven acute myeloid leukemia. Thirteen of the 15 patients with no known disease developed acute leukemia in from one to 49 months after the biopsy of their tumors (mean 10 months). Most tumors occurring in patients with a known myeloproliferative disorder were associated with blast crisis. The authors' cases displayed a morphologic range from well-differentiated to those tumors that displayed virtually no evidence of differentiation by conventional microscopy. It was therefore not surprising that most tumors were originally diagnosed as lymphoma. Chloro-acetate esterase (CAE) stains were performed on 56 tumors and 47 were studied with antilysozyme immunoperoxidase technique. Fifty-six of the 57 specimens studied by either technique were positive. Antilysozyme immunoperoxidase stains were particularly useful in confirming the diagnosis.
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            Prognostic factors of treatment outcomes in patients with granulocytic sarcoma.

            To investigate the possible prognostic factors of survival outcomes in patients with granulocytic sarcoma (GS). We retrospectively investigated the prognostic factors determining survival in 24 patients with GS using Kaplan-Meier survival analysis followed by log rank tests. We evaluated gender, age, location, GS antedating leukemia, underlying disorders, treatment type and stem cell transplantation. The 5-year survival rate for the patients with GS was 21%. The patients undergoing chemotherapy had a significantly longer survival time compared to those who did not (p = 0.0009). We found no difference in the 5-year survival rate among the patients undergoing chemotherapy combined with radiation or surgery. Patients with chronic myelogenous leukemia and myelodysplastic disorders had worse survival rates (p = 0.0028). Early diagnosis with biopsy and early chemotherapy can improve survival outcome. Local radiation or surgery can improve symptoms but does not influence survival outcomes. Copyright 2009 S. Karger AG, Basel.
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              Allogeneic hematopoietic stem cell transplantation for isolated and leukemic myeloid sarcoma in adults: a report from the Acute Leukemia Working Party of the European group for Blood and Marrow Transplantation.

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                Author and article information

                Contributors
                drwang1013@126.com
                wnmc2012@163.com
                laoban1968@126.com
                anqingxuezi@163.com
                Journal
                BMC Pulm Med
                BMC Pulm Med
                BMC Pulmonary Medicine
                BioMed Central (London )
                1471-2466
                8 November 2019
                8 November 2019
                2019
                : 19
                : 204
                Affiliations
                [1 ]GRID grid.452929.1, Department of Internal Medicine, , the First Affiliated Hospital of Wannan Medical College, ; Zheshan West Road, Wuhu, 241000 China
                [2 ]GRID grid.452929.1, Department of Hematology, , the First Affiliated Hospital of Wannan Medical College, ; Zheshan West Road, Wuhu, 241000 China
                [3 ]GRID grid.452929.1, Department of Respiration, , the First Affiliated Hospital of Wannan Medical College, ; Zheshan West Road, Wuhu, 241000 China
                Author information
                http://orcid.org/0000-0002-9290-700X
                Article
                975
                10.1186/s12890-019-0975-7
                6839095
                31703576
                361a528d-ebac-454f-b8cc-5e336afbc27d
                © The Author(s). 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 15 June 2019
                : 28 October 2019
                Categories
                Case Report
                Custom metadata
                © The Author(s) 2019

                Respiratory medicine
                bronchus,carcinoma,pulmonary mass,myeloid sarcoma
                Respiratory medicine
                bronchus, carcinoma, pulmonary mass, myeloid sarcoma

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