Lymph nodes & spleen, nonlymphoma
Lymph node & spleen-nonlymphoid neoplasms
Chronic myeloid leukemia, extramedullary


Topic Completed: 1 February 2014

Minor changes: 22 November 2020

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PubMed Search: Chronic myelogenous leukemia[TI] lymph node


Patricia Tsang, M.D., M.B.A.
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Cite this page: Tsang, P. Chronic myeloid leukemia, extramedullary. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodescml.html. Accessed November 30th, 2020.
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

AFIP images

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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