Lökomoid Reaksiyon ve Konglemere Lenfadenopatiler İle Prezente Olan Granülositik Sarkom Olgusu

Year 2018, Volume: 40 Issue: 2, 70 - 74, 12.03.2018

Hava Üsküdar Teke , Hamide Eda Tatlıpınar Neslihan Andıç Eren Gündüz , Funda Canaz , Olga Meltem Akay

https://doi.org/10.20515/otd.349655

Abstract

Granülositik
sarkom, myeloid seri progenitör hücrelerini içeren ekstrameduller alanlarda yer
alan tümöral bir kitledir. Genellikle kemik, periost, yumuşak dokuda lokalize
olurlar. Granülositik sarkom, çok yaygın olarak, akut myeloid löseminin klinik
bir başlangıç bulgusu olarak kendini gösterebilir. 42 yaşında olan ve boğaz
ağrısı nedenli kliniğimize başvuran olgumuzun fizik muayenesinde tonsiller
hipertrofik, hepatosplenomegali ve multipl konglemere özellikte
lenfadenopatileri mevcuttu. Laboratuvar incelemesinde, hemoglobin 7.2 gr/dl,
lökosit 144x109/L platelet 36x109/L saptandı. Periferik yayma ve kemik iliği
aspirasyon bulguları ile akut veya kronik myeloid lösemi düşünülmeyen hastaya
lenfoma ön tanısı ile eksizyonel lenf nodu biyopisi yapıldı ve biyopsi sonucu
granulositik sarkom ile uyumlu saptanarak 7+3 remisyon-indüksiyon kemoterapisi
başlandı. Hasta progresyon ve sepsis nedenle ex oldu. Sonuç olarak; lökomoid
reaksiyonla gelen ve patolojik lenfadenopatileri olan hastalarda tabloya
granülositik sarkomun eşlik edebileceği düşünülmeli ve doku tanısı ile ön tanı
desteklenmelidir.

Keywords

Lenfadenopati, granulositik sarkom

References

• 1. Pathak B, Bruchim I, Brisson ML, Hammouda W, Bloom C, Gotlieb WH. Granulocytic sarcoma presenting as tumors of the cervix. Gynecol Oncol 2005; 98: 493-497. 2. Shea B, Reddy V, Abbitt P, Benda R, Douglas V, Wingard J. Granulocytic sarkoma (chloroma) of the breast: a diagnostic dilemma and review of the literature. Breast J 2004; 10: 48-53. 3. Greer JP, Baer MR, Kinney MC. Acute Myeloid Leukemia in Adults.in Wintrobe’s clinical hematology. Lippincott Williams&Wilkins. Philedelphia, USA, 11th ed., 2004; pp 2103-2104. 4. Lichtman MA. Classification and clinical manifestations of the clonal myeloid disorders, in Williams Hematology. The McGraw-Hill Co. New York, USA, 7th ed., 2006; pp 1152. 5. Sung Co ,Ko YH, Park CK, Jang KT, Heo JS. Isolated biliary granulocytic sarcoma followed by acute myelogeneous leukemia with multilineage dysplasia: a case report and literature review. J Korean Med Sci 2006; 21: 550-554. 6. Palit A, Inamadar AC, Athanikar SB, Sampagavi VV, Deshmukh NS, Yelikar BR. An elderly man with a violaceous nodule and anemia. Indian J Dermatol Venereol Leprol 2005; 71; 376-378. 7. Avni B, Koren-Michowitz M. Myeloid sarcoma: current approach and therapeutic options. Therapeutic Advances in Hematology. 2011;2(5):306–316.
• 8. Nigam JS, Misra V, Kumar V, Varma K. Aleukemic granulocytic sarcoma presenting at multiple sites: ovary, breast and soft tissue. Rare Tumors. 2012;4(3, article e36)
• 9. Halkes CJM, Dijstelbloem HM, Eelkmann Rooda SJ, Kramer MHH. Extreme leucocytosis: not always leukaemia. Netherlands Journal of Medicine. 2007;65(7):248–251
• 10. George TI. Malignant or benign leucocytosis. Hematology American Society of Hematology Education Program. 2012;2012:475–484.
• 11.Ngu IW, Sinclair EC, Greenaway S, Greenberg ML. Unusual presentation of granulocytic sarcoma in the breast: a case report and review of the literature. Diagn Cytopathol. 2001;24(1):5
• 12. Chang C-C, Eshoa C, Kampalath B, Shidham VB, Perkins S. Immunophenotypic profile of myeloid cells in granulocytic sarcoma by immunohistochemistry: correlation with blast differentiation in bone marrow. The American Journal of Clinical Pathology. 2000;114(5):807–811.
• 13. Swerlow SH, Campo E, Haris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edition. Lyon, France: IARC Press; 2008. 3-57. 14. Odom RB, James WD, Berger TG: Andrew’s Diseases of the Skin. Clinical Dermatology. 9th edition. Philadelphia, W.B. Saunders Company, 2000;939 15. Lee RG, Bitcell TC, Foerster J, Athens JN, Lukes JN: Cutaneus T cell lymphoma mycosis fungoides and Sezary syndrome. Wintrobe’s Clinical Hematology. John ZK, Salhany KE, Greer JP, King JR.10th edition. Philadelphia, Lippincott Williams & Wilkins, 1999:2586-2587. 16. Sadick N, Edlin D, Myskowski PL, et al. Granulocytic sarcoma. A new finding in the setting of preleukemia. Arch Dermatol 1984;120:1341-1343 17. Pui MH, Fletcher BD, Langston JW. Granulocytic sarcoma in childhood leukemia: imaging features. Radiology. 1994;190(3):698-702. 18. Paydas S, Zorludemir S, Ergin M. Granulocytic sarcoma: 32 cases and review of the literature. Leuk Lymphoma. 2006;47(12):2527-2541.
• 19. Narayan P, Murthy V, Su M, Woel R, Grossman IR, Chamberlain RS. Primary myeloid sarcoma masquerading as an obstructing duodenal carcinoma. Case Reports in Hematology. 2012;2012:7 pages.490438