Uterine relapse of Philadelphia chromosome-negative acute lymphoblastic leukemia
| Autor: | Yasuo Mori, Yuri Naghiro, Takashi Nakaike, Takao Kodama, Sayaka Kawano, Hidenobu Ochiai, Tomonori Hidaka, Ikuo Kikuchi, Toshihiko Imamura, Akiyoshi Takami, Noriaki Kawano, Yuka Sugimoto, Tetsuo Maeda, Koichi Mashiba, Kosuke Marutsuka, Kazuya Shimoda, Kiyoshi Yamashita, Taro Tochigi |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Philadelphia-negative B-ALL
Pathology medicine.medical_specialty medicine.medical_treatment Karyotype Uterus Case Report MRI features Lesion 03 medical and health sciences 0302 clinical medicine Bone Marrow Medicine Humans Philadelphia Chromosome uterine relapse Chemotherapy business.industry Histology General Medicine Middle Aged Precursor Cell Lymphoblastic Leukemia-Lymphoma medicine.disease refractory clinical course Transplantation Haematopoiesis medicine.anatomical_structure 030220 oncology & carcinogenesis Uterine Neoplasms Female Bone marrow medicine.symptom Neoplasm Recurrence Local business Infiltration (medical) 030215 immunology |
| Zdroj: | Journal of Clinical and Experimental Hematopathology : JCEH |
| ISSN: | 1880-9952 1346-4280 |
| Popis: | The relapse of acute lymphoblastic leukemia (ALL) usually involves the bone marrow, with the central nervous system being the most frequent extramedullary site. The relapse of ALL in the female genital organs, particularly the uterus, is markedly rare. We report such a patient who developed relapse in the bone marrow and uterus. The uterine lesion, which presented as abnormal uterine bleeding, consisted of a mass on MRI and proliferation of ALL cells on histology. MRI revealed a heterogeneous high-intensity mass (T2-WI/D-WI) with a diameter of 6.8 cm, a notable decrease in the apparent diffusion coefficient (ADC), and mild enhancement by contrast enhancement study. Histological findings of the uterine cervix demonstrated the infiltration of ALL. The patient achieved remission by allogeneic haplo-identical hematopoietic stem-cell transplantation, but died of complications of the transplantation. This case suggested that attention should be paid to the uterus as a site of extramedullary relapse. In addition, abnormal uterine bleeding, which is a common sign of hormonal imbalance and hormone replacement therapy after chemotherapy, may be an initial sign of extramedullary recurrence. To confirm uterine relapse as an intractable disease, the accumulation of more cases is required. |
| Databáze: | OpenAIRE |
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