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CASE REPORT
Year : 2017  |  Volume : 1  |  Issue : 1  |  Page : 7-9

Clinicopathological contributions at diagnosis of bilineal extramedullary blast proliferation


1 Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh, India
2 Department of Laboratory Medicine and Molecular Genetics, Tata Medical Centre, Kolkata, West Bengal, India
3 Department of Cytogenetics, Tata Medical Centre, Kolkata, West Bengal, India
4 Department of Pathology, Tata Medical Centre, Kolkata, West Bengal, India

Correspondence Address:
Sonali Susmita Nayak
Department of Pathology, Homi Bhabha Cancer Hospital and Research Centre, Visakhapatnam, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/oji.oji_3_17

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Blast phase of chronic myelogenous leukemia (CML) presenting as extramedullary blast proliferation is seen in only 6%–10% of cases. A bilineal blast proliferation of myeloid and T-cell lymphoid lineage is even rarer. These cases usually have various additional cytogenetic clonal abnormalities along with the presence of Philadelphia chromosome (Ph chromosome) or BCR-ABL fusion gene. Considered to be an aggressive hematologic malignancy, it needs prompt initiation of chemotherapy along with Imatinib and stem cell transplant. We report here a case of bilineal extramedullary blast proliferation in a 33-year-old male presenting with an initial diagnosis of CML. Lymphoblastic lymphoma, de novo acute myeloid leukemia are considered as close differentials; absence of proper clinical findings, lack of other components of myeloid differentiation can be potential pitfalls in arriving at a correct diagnosis.


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