Myeloid sarcoma involving the breast

Jose R. Valbuena, Joan Admirand, Gabriela Gualco, L. Jeffrey Medeiros

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Context. - Myeloid sarcoma is a neoplasm of myeloid cells that can arise before, concurrent with, or following acute myeloid leukemia. Rarely, it can also occur as an isolated mass. Objective. - To describe the clinicopathologic features of 6 patients with myeloid sarcoma involving the breast. Design. - Clinical information for all 6 patients was obtained from the medical record. Routine hematoxylin-eosin-stained slides; naphthol AS-D chloroacetate stain; and immunohistochemical stains for myeloid, B-cell, and T-cell antigens were prepared. Results. - There were 6 women with a median age of 52 years (range, 31-73 years). Two patients presented with isolated tumors of the breast, with no history or subsequent development of acute myeloid leukemia. In 3 patients, the breast tumors represented relapse of acute myeloid leukemia. One patient who presented initially with myeloid sarcoma involving the breast, skin, and spleen was lost to follow-up. Histologically, these tumors were classified as well differentiated (n = 3), poorly differentiated (n = 2), and blastic (n = 1). Naphthol AS-D chloroacetate esterase was positive in all 3 cases assessed. Immunohistochemistry showed that myeloperoxidase (n = 5) and CD43 (n = 3) were positive, and CD3 (n = 5) and CD20 (n = 5) were negative in all cases assessed. Lysozyme was positive in 4 (80%) of 5; CD117 was positive in 2 (67%) of 3; and single cases were positive for CD45 (1/3), TdT (1/2), CD79a, and the PAX5 gene product. Conclusions. - Myeloid sarcoma involving the breast is uncommon. In the literature, as in this study, these tumors most often represent relapse or the initial presentation of acute myeloid leukemia. However, 2 of the cases we report presented with isolated masses, without a history or subsequent development of acute myeloid leukemia at last follow-up. Immunohistochemical studies are extremely helpful for recognizing isolated myeloid sarcoma.

Original languageEnglish (US)
Pages (from-to)32-38
Number of pages7
JournalArchives of Pathology and Laboratory Medicine
Volume129
Issue number1
StatePublished - Jan 1 2005

Fingerprint

Myeloid Sarcoma
Acute Myeloid Leukemia
Breast
Myeloid Cells
Coloring Agents
History
Naphthol AS D Esterase
Breast Neoplasms
Recurrence
Neoplasms
Lost to Follow-Up
Viral Tumor Antigens
Hematoxylin
Eosine Yellowish-(YS)
Muramidase
Peroxidase
Medical Records
B-Lymphocytes
Spleen
Immunohistochemistry

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medical Laboratory Technology

Cite this

Valbuena, J. R., Admirand, J., Gualco, G., & Medeiros, L. J. (2005). Myeloid sarcoma involving the breast. Archives of Pathology and Laboratory Medicine, 129(1), 32-38.

Myeloid sarcoma involving the breast. / Valbuena, Jose R.; Admirand, Joan; Gualco, Gabriela; Medeiros, L. Jeffrey.

In: Archives of Pathology and Laboratory Medicine, Vol. 129, No. 1, 01.01.2005, p. 32-38.

Research output: Contribution to journalArticle

Valbuena, JR, Admirand, J, Gualco, G & Medeiros, LJ 2005, 'Myeloid sarcoma involving the breast', Archives of Pathology and Laboratory Medicine, vol. 129, no. 1, pp. 32-38.
Valbuena JR, Admirand J, Gualco G, Medeiros LJ. Myeloid sarcoma involving the breast. Archives of Pathology and Laboratory Medicine. 2005 Jan 1;129(1):32-38.
Valbuena, Jose R. ; Admirand, Joan ; Gualco, Gabriela ; Medeiros, L. Jeffrey. / Myeloid sarcoma involving the breast. In: Archives of Pathology and Laboratory Medicine. 2005 ; Vol. 129, No. 1. pp. 32-38.
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abstract = "Context. - Myeloid sarcoma is a neoplasm of myeloid cells that can arise before, concurrent with, or following acute myeloid leukemia. Rarely, it can also occur as an isolated mass. Objective. - To describe the clinicopathologic features of 6 patients with myeloid sarcoma involving the breast. Design. - Clinical information for all 6 patients was obtained from the medical record. Routine hematoxylin-eosin-stained slides; naphthol AS-D chloroacetate stain; and immunohistochemical stains for myeloid, B-cell, and T-cell antigens were prepared. Results. - There were 6 women with a median age of 52 years (range, 31-73 years). Two patients presented with isolated tumors of the breast, with no history or subsequent development of acute myeloid leukemia. In 3 patients, the breast tumors represented relapse of acute myeloid leukemia. One patient who presented initially with myeloid sarcoma involving the breast, skin, and spleen was lost to follow-up. Histologically, these tumors were classified as well differentiated (n = 3), poorly differentiated (n = 2), and blastic (n = 1). Naphthol AS-D chloroacetate esterase was positive in all 3 cases assessed. Immunohistochemistry showed that myeloperoxidase (n = 5) and CD43 (n = 3) were positive, and CD3 (n = 5) and CD20 (n = 5) were negative in all cases assessed. Lysozyme was positive in 4 (80{\%}) of 5; CD117 was positive in 2 (67{\%}) of 3; and single cases were positive for CD45 (1/3), TdT (1/2), CD79a, and the PAX5 gene product. Conclusions. - Myeloid sarcoma involving the breast is uncommon. In the literature, as in this study, these tumors most often represent relapse or the initial presentation of acute myeloid leukemia. However, 2 of the cases we report presented with isolated masses, without a history or subsequent development of acute myeloid leukemia at last follow-up. Immunohistochemical studies are extremely helpful for recognizing isolated myeloid sarcoma.",
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