Journal Club: Myeloid sarcoma- The clinical, morphological, and immunohistochemical features
Written By : Dr. Nandita Mohan
Published On 2025-04-26 04:30 GMT | Update On 2025-04-26 04:30 GMT
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This is an original article published in the Asian Journal of Oncology published by Scientific Scholar.
To give a brief about Myeloid sarcoma (MS), it is a tumor mass formed by the collection of myeloid blasts at sites other than bone marrow. MS can occur as an isolated mass or concurrently as acute myeloid leukemia (AML) in bone marrow or in a case of myeloproliferative neoplasm/myelodysplastic neoplasm.
The study aimed to highlight the varied presentation and morpho-immunohistochemistry guide to recognize this entity in biopsy for its therapeutic connotation.
The present study is a retrospective analysis; in which the cases diagnosed as MS between 2014 and 2021 were included. Clinicopathological details like age, gender, site of biopsy, bone marrow status, histopathology, immunohistochemistry, treatment, and follow-up information, where available, were included.
It was found that a total of 24 cases were diagnosed with the age range of 2–67 years where the male: female ratio was 1.1:1.
The sites at presentation were: spinal/paraspinal region, lymph nodes, breast, cervix, orbit, nasal cavity/nasopharynx, skin, mediastinum, cheek swelling, central nervous system, and chest wall.
De novo MS was present in seven cases while concurrent AML in peripheral blood /bone marrow was noted in six cases.
Histopathological analysis revealed three morphological types: differentiated, monocytic, and undifferentiated. IHC done in 22 cases showed positive for Leucocyte common antigen.
Hence, the present case series showcases the common and uncommon clinical presentation of MS cases. The varied sites of involvement, non-diagnostic radiological features, and undifferentiated morphology make diagnosis a challenge. The authors suggest in tandem use of broad IHC panel, flow cytometry, and molecular studies for arriving at the right diagnosis.
Ref: Mundada MC, Ahmed F, Kodandapani S, G S, Boyella P, Patil V, et al. Myeloid sarcoma: A seven year retrospective study from tertiary cancer care center, illustrating the clinical, morphological and immunohistochemical features. Asian J Oncol. 2024;10:12. doi: 10.25259/ASJO_35_2023
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