Hypercalcemia and diffuse osteolytic lesions in a 45-year-old patient with myeloid sarcoma with megakaryocytic differentiation

Acute megakaryocytic leukemia is a rare form of acute myeloid leukemia that carries a poor prognosis. As most cases of osteolytic lesions are due to plasma cell and myeloid malignancies, maintaining a broad differential directly influences clinical course. We document a 45-year-old patient with prog...

Full description

Bibliographic Details
Main Authors: Aditya Goud, Abdelhai Abdelqader, Chanukya Dahagam, Ramez Jabaji, Pallavi Kumar, Albert Aboulafia, Stephen Selinger
Format: Article
Language:English
Published: Greater Baltimore Medical Center 2016-04-01
Series:Journal of Community Hospital Internal Medicine Perspectives
Subjects:
Online Access:http://www.jchimp.net/index.php/jchimp/article/view/30327/pdf_140
Description
Summary:Acute megakaryocytic leukemia is a rare form of acute myeloid leukemia that carries a poor prognosis. As most cases of osteolytic lesions are due to plasma cell and myeloid malignancies, maintaining a broad differential directly influences clinical course. We document a 45-year-old patient with progressive constitutional symptoms, osteolytic bone lesions in the setting of hypercalcemia, who developed acutely worsening pancytopenia. The diagnosis of myeloid sarcoma with megakaryocytic differentiation was made after obtaining tissue from osteolytic bone that stained strong for CD34. Immunohistochemical testing underscores the importance of how serologic and urine testing remains limited and can delay early diagnosis in this disease.
ISSN:2000-9666