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Myeloid sarcoma occurring concurrently with drug-induced gingival enlargement.

AbstractBACKGROUND:
Myeloid sarcoma is an extramedullary malignancy of myeloblasts. An unusual case of myeloid sarcoma presenting in the gingiva and affected by drug-induced gingival enlargement is presented.
METHODS:
A 63-year-old male taking amlodipine for his hypertension presented with a 3-week gingival enlargement. Although the obvious clinical impression was that of drug-induced gingival enlargement, an incisional biopsy was performed to corroborate chemical enlargement while ruling out diseases such as lymphoma and leukemia.
RESULTS:
Microscopic examination of the thickened gingiva revealed surface stratified squamous epithelium having needle-like rete pegs characteristic of drug-induced gingival enlargement. Beneath the surface epithelium, the fibrous tissue was virtually replaced by a dense infiltrate of malignant cells. Immunohistochemical studies were performed with CD117 and myeloperoxidase identifying the malignant cell population as myeloblasts, leading to a diagnosis of myeloid sarcoma.
CONCLUSION:
Myeloid sarcoma and hematopoietic malignancies must be included in a differential diagnosis of gingival enlargement until the definitive diagnosis is reached by histologic/laboratory examination.
AuthorsAngela J Yoon, Carla Pulse, Lori D Cohen, Timothy A Lew, David J Zegarelli
JournalJournal of periodontology (J Periodontol) Vol. 77 Issue 1 Pg. 119-22 (Jan 2006) ISSN: 0022-3492 [Print] United States
PMID16579712 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Antihypertensive Agents
  • Amlodipine
  • Proto-Oncogene Proteins c-kit
  • Leukocyte Common Antigens
Topics
  • Amlodipine (adverse effects)
  • Antihypertensive Agents (adverse effects)
  • Biopsy
  • Diagnosis, Differential
  • Epithelium (pathology)
  • Gingival Neoplasms (complications, diagnosis)
  • Gingival Overgrowth (chemically induced, diagnosis)
  • Humans
  • Leukemia, Myeloid (complications, diagnosis)
  • Leukocyte Common Antigens (analysis)
  • Male
  • Middle Aged
  • Proto-Oncogene Proteins c-kit (analysis)

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