Granulocytic sarcoma: Difference between revisions
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==Overview== | ==Overview== | ||
==Historical Perspective== | ==Historical Perspective== | ||
* | * The condition now known as chloroma was first described by the British [[physician]] A. Burns in 1811<ref>Burns A. Observations of surgical anatomy, in Head and Neck. London, England, Royce, 1811, p. 364.</ref>, although the term ''chloroma'' did not appear until 1853.<ref>King A. A case of chloroma. Monthly J Med 17:17, 1853.</ref> This name is derived from the [[Greek language|Greek]] word ''chloros'' (green), as these tumors often have a green tint due to the presence of [[myeloperoxidase]]. The link between chloroma and [[acute leukemia]] was first recognized in 1902 by Dock and Warthin.<ref>Dock G, Warthin AS. A new case of chloroma with leukemia. Trans Assoc Am Phys 19:64, 1904, p. 115.</ref> However, because up to 30% of these tumors can be white, gray, or brown rather than green, the more correct term ''granulocytic sarcoma'' was proposed by Rappaport in 1967<ref>Rappaport H. Tumors of the hematopoietic system, in Atlas of Tumor Pathology, Section III, Fascicle 8. Armed Forces Institute of Pathology, Washington DC, 1967, pp. 241-247.</ref> and has since become virtually synonymous with the term ''chloroma''. | ||
* Currently, any extramedullary manifestion of acute myeloid leukemia can be termed a granulocytic sarcoma or chloroma. Specific terms which overlap with granulocytic sarcoma include: | |||
* | * Leukemia cutis, describing infiltration of the [[dermis]] (skin) by leukemic cells, which is also referred to as cutaneous granulocytic sarcoma. | ||
* Meningeal leukemia, or invasion of the [[subarachnoid space]] by leukemic cells, is usually considered distinct from chloroma, although very rarely occurring solid [[central nervous system]] tumors composed of leukemic cells can be termed chloromas. | |||
==Classification== | ==Classification== | ||
*[Disease name] may be classified according to [classification method] into [number] subtypes/groups: | *[Disease name] may be classified according to [classification method] into [number] subtypes/groups: | ||
Revision as of 14:51, 13 May 2016
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ammu Susheela, M.D. [2]
Synonyms and keywords: Chloroma, Myeloid Sarcoma, Myeloid Sarcomas, Myeloid Cell Tumor, Granulocytic Sarcoma, Extramedullary Myeloid Cell Tumor
Overview
Historical Perspective
- The condition now known as chloroma was first described by the British physician A. Burns in 1811[1], although the term chloroma did not appear until 1853.[2] This name is derived from the Greek word chloros (green), as these tumors often have a green tint due to the presence of myeloperoxidase. The link between chloroma and acute leukemia was first recognized in 1902 by Dock and Warthin.[3] However, because up to 30% of these tumors can be white, gray, or brown rather than green, the more correct term granulocytic sarcoma was proposed by Rappaport in 1967[4] and has since become virtually synonymous with the term chloroma.
- Currently, any extramedullary manifestion of acute myeloid leukemia can be termed a granulocytic sarcoma or chloroma. Specific terms which overlap with granulocytic sarcoma include:
- Leukemia cutis, describing infiltration of the dermis (skin) by leukemic cells, which is also referred to as cutaneous granulocytic sarcoma.
- Meningeal leukemia, or invasion of the subarachnoid space by leukemic cells, is usually considered distinct from chloroma, although very rarely occurring solid central nervous system tumors composed of leukemic cells can be termed chloromas.
Classification
- [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
- [group1]
- [group2]
- [group3]
- Other variants of [disease name] include [disease subtype 1], [disease subtype 2], and [disease subtype 3].
Pathophysiology
- A granulocytic sarcoma is a solid tumor composed of immature malignant white blood cells called myeloblasts. A chloroma is an extramedullary manifestion of acute myeloid leukemia; in other words, it is a solid collection of leukemic cells occurring outside of the bone marrow.
- The pathogenesis of [disease name] is characterized by [feature1], [feature2], and [feature3].
- The [gene name] gene/Mutation in [gene name] has been associated with the development of [disease name], involving the [molecular pathway] pathway.
- On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
- On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].
Causes
- [Disease name] may be caused by either [cause1], [cause2], or cause3].
- [Disease name] is caused by a mutation in the [gene1], [gene2], or gene3] gene[s].
- There are no established causes for [disease name].
Differentiating [disease name] from other Diseases
- [Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as:
- [Differential dx1]
- [Differential dx2]
- [Differential dx3]
Epidemiology and Demographics
- The prevalence of [disease name] is approximately [number or range] per 100,000 individuals worldwide.
- In [year], the incidence of [disease name] was estimated to be [number or range] cases per 100,000 individuals in [location].
Age
- Patients of all age groups may develop [disease name].
- [Disease name] is more commonly observed among patients aged [age ange] years old.
- [Disease name] is more commonly observed among [elderly patients/young patients/children].
Gender
- [Disease name] affects men and women equally.
- [Gender 1] are more commonly affected with [disease name] than [gender 2].
- The [gender 1] to [Gender 2] ratio is approximately [number > 1] to 1.
Race
- There is no racial predilection for [disease name].
- [Disease name] usually affects individuals of the [race 1] race.
- [Race 2] individuals are less likely to develop [disease name].
Risk Factors
- Common risk factors in the development of [disease name] are [risk factor 1], [risk factor 2], [risk factor 3], and [risk factor 4].
Natural History, Complications and Prognosis
- The majority of patients with [disease name] remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is pproximately [#%].
Diagnosis
Diagnostic Criteria
- The diagnosis of [disease name] is made when at least [number] of the ollowing [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
Symptoms
- [Disease name] is usually asymptomatic.
- Symptoms of [disease name] may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
Physical Examination
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
Laboratory Findings
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
Imaging Findings
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
Treatment
Medical Therapy
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
Surgery
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
Prevention
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followedup every [duration]. Followupm testing includes [test 1], [test 2], and [test 3].
References
- ↑ Burns A. Observations of surgical anatomy, in Head and Neck. London, England, Royce, 1811, p. 364.
- ↑ King A. A case of chloroma. Monthly J Med 17:17, 1853.
- ↑ Dock G, Warthin AS. A new case of chloroma with leukemia. Trans Assoc Am Phys 19:64, 1904, p. 115.
- ↑ Rappaport H. Tumors of the hematopoietic system, in Atlas of Tumor Pathology, Section III, Fascicle 8. Armed Forces Institute of Pathology, Washington DC, 1967, pp. 241-247.
[[Category:Pick One of 28 Approved