Iranian Journal of Immunology

Differential diagnosis from isolated lymphoid extramedullary blast crisis from secondary non-Hodgkin lymphoma in chronic myelogenous leukemia: a case report and literature review

Document Type : Case Report

Authors

Tingting Wang 1
Li Fu 1
Na Wei 2
Xiaoge Zhou 3
Xiaodan Zheng 3
Li Li 1
Zhao Wang 2

1 Department of International Medical Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

2 Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

3 Department of Pathology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China

https://doi.org/10.22034/iji.2021.84496.1661
Abstract
Case: 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.

Keywords

Chronic myelogenous leukemia
extramedullary blast crisis
secondary non-Hodgkin lymphoma
Iranian Journal of Immunology
Volume 18, Issue 2
Spring 2021
Pages 163-169

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