Lymph nodes & spleen, nonlymphoma
Lymph node & spleen-nonlymphoid neoplasms
Chronic myeloid leukemia, extramedullary
Author: Patricia Tsang, M.D., M.B.A.
Last author update: 1 February 2014
Last staff update: 18 July 2022
Copyright: 2003-2023, PathologyOutlines.com, Inc.
PubMed Search: Chronic myelogenous leukemia[TI] lymph node
Table of Contents
Definition / general | Terminology | Case reports | Treatment | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Electron microscopy images | Molecular / cytogenetics description | Differential diagnosis | Additional referencesCite this page: Tsang, P. Chronic myeloid leukemia, extramedullary. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/lymphnodescml.html. Accessed March 22nd, 2023.
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
- Anaplastic plasma cell myeloma
- Granulocytic sarcoma related to acute myeloid leukemia
- Metastatic carcinoma to lymph node
Additional references
