Lymph Node Myeloid Sarcoma as a First Presentation of CML Blast Crisis: A Rare Case Report with Review of Literature

Abstract

Myeloid Sarcoma (MS) is an extra-medullary accumulation of the immature cells of granulocytic cell lineage. It has been reported commonly in the setting of acute myelogenous leukaemia, however its occurrence in Chronic Myeloid Leukaemia (CML), though reported as rare, is also common, although only isolated case reports are available. It is commonly misdiagnosed as non Hodgkin lymphoma. Occurrence of MS in a patient with CML defines the case as an extra medullary blast crisis, even without evidence of systemic disease. It is a tell-tale sign of poor prognosis. Here we describe a case of a 45-year-old female who presented with prolonged febrile illness with generalised lymphadenopathy who on extensive workup turned out to be MS as a first presentation of CML in blast crisis. We will review the intricacies of the case, discussing the diagnostic conundrum and treatment dilemma we faced and the systematic approach we followed to manage the patient.

Keywords

• chemotherapy
• chronic myeloid leukaemia
• granulocytic sarcoma