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.
Figure 1:
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