Rare Case of Mixed Phenotype Acute Leukemia Presenting as a Myeloid Sarcoma Without Leukemic Involvement.

Abstract

INTRODUCTION:

Mixed phenotype acute leukemia (MPAL) is a rare type of acute leukemia with immunophenotypic features of both myeloid-derived and lymphoid-derived lineages.

CASE PRESENTATION:

We present an atypical case of a 32-year-old woman presenting with an anterior mediastinal mass and pericardial/pleural involvement that was initially diagnosed as primary mediastinal diffuse large B-cell lymphoma. However, flow cytometry on pleural fluid confirmed the diagnosis of MPAL of B-cell/myeloid lineage without peripheral blood/bone marrow involvement. The patient was treated with an acute lymphoblastic leukemia-type regimen and proceeded with myeloablative allogeneic hematopoietic cell transplantation in first complete remission.

CONCLUSION:

MPAL can rarely present with isolated extramedullary disease without leukemic involvement and can often be misdiagnosed as a non-Hodgkin lymphoma. Careful integration of all the clinical data, particularly flow cytometry results, can clarify the diagnosis and change the treatment plan.

• Authors: Jeffrey Means, David Feldman, Allison Shaw, Khoan Vu
• Journal: The Permanente journal (Perm J) Vol. 26 Issue 1 Pg. 132-136 (04 05 2022) ISSN: 1552-5775 [Electronic] United States
• PMID: 35609165 (Publication Type: Case Reports, Journal Article)

Topics

• Acute Disease
• Humans
• Immunophenotyping
• Leukemia, Myeloid, Acute (diagnosis, therapy)
• Phenotype
• Precursor Cell Lymphoblastic Leukemia-Lymphoma
• Sarcoma, Myeloid (diagnosis)