Secrets of a Heart Laid Bare

Clinical Image

Ann Hematol Oncol. 2019; 6(2): 1231.

Secrets of a Heart Laid Bare

Santy L¹ and Deeren D²*

¹Department of Internal Medicine, University of Leuven, Belgium

²Department of Hematology, AZ Delta Roeselare, Belgium

*Corresponding author: Deeren D, AZ Delta Roeselare, Wilgenstraat 2 8800 Roeselare, Belgium

Received: January 16, 2019; Accepted: January 28, 2019;Published: February 04, 2019

Image Description

A 48-year-old man presented at the emergency department because of a progressive ulcer (Image A) on the medial left thigh, which appeared two months ago. He mentioned weight loss (twenty kilograms over 6 months), fever and night sweats for the past three months. Physical examination revealed a painless, heart-shaped ulcerating wound (length 7 centimeter, width 5 centimeter), fibrinous with necrotic black spots. Laboratory tests show microcytic anemia (6 g/dL), thrombocytopenia (126.000/μL) and the presence of blasts. Flow cytometry confirmed 31% myeloblasts suggesting acute myeloid leukemia, which was confirmed on bone marrow biopt and aspirate (Image B). A biopsy of the ulcer showed myeloid sarcoma. Remission induction chemotherapy (cytarabin-idarubicin) was started, together with local wound care. After four weeks, significant reduction of the ulcer size was already observed.

Myeloid sarcoma is a rare neoplastic disease consisting of myeloid blasts, described as an extra medullary manifestation of acute or chronic myeloid leukemia.

Citation: Santy L and Deeren D. Secrets of a Heart Laid Bare. Ann Hematol Oncol. 2019; 6(2): 1231.