Author/Authors :
Wang, Tingting Department of International Medical Center - Beijing Friendship Hospital - Capital Medical University - Beijing, China , Fu, Li Department of International Medical Center - Beijing Friendship Hospital - Capital Medical University - Beijing, China , Wei, Na Department of Hematology - Beijing Friendship Hospital - Capital Medical University - Beijing, China , Zhou, Xiaoge Department of Pathology - Beijing Friendship Hospital - Capital Medical University - Beijing, China , Zheng, Xiaodan Department of Pathology - Beijing Friendship Hospital - Capital Medical University - Beijing, China , Li, Li Department of International Medical Center - Beijing Friendship Hospital - Capital Medical University - Beijing, China , Wang, Zhao Department of Hematology - Beijing Friendship Hospital - Capital Medical University - Beijing, China
Abstract :
Extramedullary blast crisis (EBC) is a special kind of blast crisis
of chronic myelogenous leukemia (CML). It is more likely to be
misdiagnosed as lymphoma when EBC cells are of lymphoid cell
lineage and lymphadenopathy is the only symptom before the final
diagnosis. In this study, we presented a patient with an unusual
presentation of CML transformation as a rapid growth of generalized
lymphadenopathy that appeared 5 months after the initial diagnosis
of CML. The patient underwent the left supraclavicular lymph node
biopsy and repeat bone marrow aspiration. The revealed CD3+,
terminal deoxynucleotidyl transferase (TdT)+, CD5+, CD23+,
myeloperoxidase (MPO)-, CD20-, cyclin D1-, CD10-, which was
consistent with the diagnosis of T-cell lymphoblastic lymphoma
(T-LBL). Fluorescence in situ hybridization (FISH) verified the
BCR-ABL rearrangement, and T-cell EBC of CML was finally
diagnosed. Our report suggested that the FISH was necessary to
distinguish isolated lymphoid extramedullary blast crisis from
secondary NHL in CML
