当前位置: X-MOL 学术Blood › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Marked paraneoplastic leukemoid reaction in a patient with mesothelioma mimicking a myeloid neoplasm
Blood ( IF 21.0 ) Pub Date : 2020-02-06 , DOI: 10.1182/blood.2019003936
Beenu Thakral 1 , Sanam Loghavi 1
Affiliation  

A 58-year-old woman was diagnosed with peritoneal epithelioid mesothelioma, postdebulking surgery. Peripheral blood showed neutrophilic leukocytosis with left-shifted granulopoiesis, anemia, and mild thrombocytosis (white blood cells [WBCs], 89 3 109/L; hemogloblin [Hb], 6.0 g/dL; platelets, 617 3 109/L). Four months later, she presented to our institution with liver metastasis, progressive marked left-shifted neutrophilic leukocytosis, and anemia (WBCs, 2843109/L; absolute neutrophil count, 272 3 109/L; Hb, 7.4 g/dL; platelets, 145 3 109/L) (panels A-B; Wright-Giemsa stain), concerning for myeloid neoplasm (MN) including myeloproliferative neoplasms (MPNs; chronic myeloid leukemia [CML], chronic neutrophilic leukemia [CNL]) or myelodysplastic syndrome/MPN. Bone marrow examination showed hypercellularity (95%) with left-shifted granulocytic hyperplasia without basophilia, eosinophilia, or morphologic dysplasia (panels C-D; hematoxylin & eosin stain [C], Wright-Giemsa stain [D]). No metastatic mesothelioma was identified. Serum granulocyte colony-stimulating factor (G-CSF) was normal. Myeloid precursors showed unremarkable immunophenotype by flow cytometry. Cytogenetic analysis showed diploid female karyotype. Fluorescence in situ hybridization was negative for BCR-ABL1. Nextgeneration sequencing (81-gene panel) including CSF3R/JAK2/ CALR/MPL and SETBP1 showed no mutations. Thus, overall findings were in keeping with a marked paraneoplastic leukemoid reaction (LR) in response to metastatic mesothelioma.

中文翻译:

模拟髓系肿瘤的间皮瘤患者出现明显的副肿瘤性类白血病反应

一名 58 岁女性在减瘤手术后被诊断出患有腹膜上皮样间皮瘤。外周血显示中性粒细胞增多,伴有左移的粒细胞生成、贫血和轻度血小板增多(白细胞 [WBC],89 3 109/L;血红蛋白 [Hb],6.0 g/dL;血小板,617 3 109/L)。四个月后,她因肝转移、进行性显着左移中性粒细胞增多和贫血(WBC,2843109/L;中性粒细胞绝对计数,272 3 109/L;Hb,7.4 g/dL;血小板,145 3 109/L)(AB 组;Wright-Giemsa 染色),涉及骨髓肿瘤(MN),包括骨髓增生性肿瘤(MPN;慢性粒细胞白血病 [CML]、慢性中性粒细胞白血病 [CNL])或骨髓增生异常综合征/MPN。骨髓检查显示细胞过多 (95%) 伴左移粒细胞增生,无嗜碱性粒细胞增多、嗜酸性粒细胞增多或形态学异常增生(图 CD;苏木精和伊红染色 [C],Wright-Giemsa 染色 [D])。没有发现转移性间皮瘤。血清粒细胞集落刺激因子(G-CSF)正常。通过流式细胞术,骨髓前体显示出不起眼的免疫表型。细胞遗传学分析显示二倍体雌性核型。BCR-ABL1 的荧光原位杂交呈阴性。包括 CSF3R/JAK2/CALR/MPL 和 SETBP1 在内的下一代测序(81 基因组)未显示突变。因此,总体结果与对转移性间皮瘤的显着副肿瘤性类白血病反应 (LR) 一致。伊红染色 [C]、Wright-Giemsa 染色 [D])。没有发现转移性间皮瘤。血清粒细胞集落刺激因子(G-CSF)正常。通过流式细胞术,骨髓前体显示出不起眼的免疫表型。细胞遗传学分析显示二倍体雌性核型。BCR-ABL1 的荧光原位杂交呈阴性。包括 CSF3R/JAK2/CALR/MPL 和 SETBP1 在内的下一代测序(81 基因组)未显示突变。因此,总体结果与对转移性间皮瘤的显着副肿瘤性类白血病反应 (LR) 一致。伊红染色 [C]、Wright-Giemsa 染色 [D])。没有发现转移性间皮瘤。血清粒细胞集落刺激因子(G-CSF)正常。通过流式细胞术,骨髓前体显示出不起眼的免疫表型。细胞遗传学分析显示二倍体雌性核型。BCR-ABL1 的荧光原位杂交呈阴性。包括 CSF3R/JAK2/CALR/MPL 和 SETBP1 在内的下一代测序(81 基因组)未显示突变。因此,总体结果与对转移性间皮瘤的显着副肿瘤性类白血病反应 (LR) 一致。BCR-ABL1 的荧光原位杂交呈阴性。包括 CSF3R/JAK2/CALR/MPL 和 SETBP1 在内的下一代测序(81 基因组)未显示突变。因此,总体结果与对转移性间皮瘤的显着副肿瘤性类白血病反应 (LR) 一致。BCR-ABL1 的荧光原位杂交呈阴性。包括 CSF3R/JAK2/CALR/MPL 和 SETBP1 在内的下一代测序(81 基因组)未显示突变。因此,总体结果与对转移性间皮瘤的显着副肿瘤性类白血病反应 (LR) 一致。
更新日期:2020-02-06
down
wechat
bug