Lymph nodes - not lymphoma
Neoplasms (not lymphoma)
Chronic myelogenous leukemia




Topic Completed: 1 February 2014

Revised: 5 February 2019

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Chronic myelogenous leukemia[TI] lymph node

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Cite this page: Tsang, P. Chronic myelogenous leukemia. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodescml.html. Accessed April 25th, 2019.
Definition / general
  • Represents extramedullary involvement of lymph node by chronic myeloid leukemia
  • CML may be in chronic phase, accelerated phase or blast crisis during nodal presentation
  • Marker of poor prognosis - usually signals impending or concurrent blast crisis
Terminology
  • Myeloid sarcoma or granulocytic sarcoma
Case reports
  • 14 year old child with biphenotypic extramedullary blast crisis as a presenting manifestation of Philadelphia chromosome+ CML (Pediatr Hematol Oncol 2007;24:195)
  • 22 year old man with concurrent chronic myelogenous leukemia and tuberculous lymphadenitis (Acta Cytol 2005;49:650)
  • 59 year old man with chronic phase chronic myelogenous leukemia with an abdominal hematopoietic tumor (Am J Hematol 2004;77:167)
  • 60 year old man with chronic myelogenous leukemia in the chronic phase with lymph node swelling (Rinsho Byori 2011;59:360)
Treatment
  • Tyrosine kinase inhibitors, such as Gleevec® (imatinib) and Tasigna (nilotinib)
  • Immunotherapy, such as interferon
  • Allogeneic stem cell transplant from matched donor
  • Chemotherapy for blast crisis
Microscopic (histologic) description
  • Mixture of mature and immature myeloid cells effacing the nodal architecture
  • May contain hematopoietic trilineages (granulocytic, erythroid and megakaryocytic)
Microscopic (histologic) images

Images hosted on PathOut server:

CML

With focal blastic transformation in liver

Involving spleen

Positive stains
Electron microscopy images

Images hosted on other servers:

Metaphase FISH showing Philadelphia chromosome

Molecular / cytogenetics description
  • Philadelphia (Ph) chromosome with t(9;22) in vast majority of cases
  • BCR-ABL fusion gene with uncontrolled tyrosine kinase production (molecular target for therapy)
  • Methods of detection: cytogenetics, FISH, PCR
Differential diagnosis
Additional references
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