CHLOROMA OF THE TESTIS AFTER ALLOGNEIC PERIPHERAL BLOOD STEM CELL TRANSPLANTATION:A CASE REPORT

同種組織周邊血掖幹細胞移植後發生的睪丸綠色瘤一病例報告

胡士文(Shih-Wen Hu) ； 黃書彬(Shu-Pin Huang) ； 楊曉芳(Sheau-Fang Yang) ； 蔡志仁(Chee-Yin Chai)

《The Kaohsiung Journal of Medical Sciences》 20卷10期 (2004/10) Pp. 506-511

摘要

綠色瘤又叫做粒性鋼胞肉瘤，是個少見的腫瘤，它可以發生於身體的任何部位，最常與急性骨髓性白血病有關。骨髓移植後以綠色瘤再發於睪丸的呈現方式在文獻上更是少見。在無臨床血癌或忽略血癌的病史時，缺乏嗜伊紅性骨髓綑胞，或常因為病理上的型態類似淋巴瘤而經常被誤診。雖然近年來有一些輔助診斷工具，診斷上還是相當困難的，診斷綠色瘤或粒性細胞肉瘤仍舊需要一些足夠的免疫組識化學染色並加臨床資料來達到正確診斷，才能給予正確的治療。我們報告一個35歲的慢性骨髓性白血病的病人，在緩解期後，以發生於睪丸的綠色瘤為疾病再發的罕見病例。在此我們將討論他的病理變化，並回顧一下文獻中的記載。

關鍵字

綠色瘤 ； 粒性細胞肉瘤 ； 吩陸骨髓性白血病 ； 睪丸

並列摘要

Chioroma, or granulocytic sarcoma, is a rare extramedullary solid hematologic cancer that affects many sites, usually in concert with acute myeloid leukemia. It is infrequently associated with other myeloproliferative disorders or chronic myelogenous leukemia. Chloroma of the testis after allogeneic bone marrow transplantation is particularly sparsely represented in the literature. It is often incorrectly diagnosed as malignant lymphoma, especially large-cell lymphoma, owing to the similarity of the histologic morphology, scanty eosinophilic myelocytes, and no or overlooked history of leukemia. Although erroneous diagnosis is decreasing with the advent of ancillary studies, the diagnosis of chloroma continues to be a nightmare for pathologists. It is thus suggested that an appropriate panel of marker studies be performed in conjunction with clinical correlation and circumspection to avoid reaching a misleading conclusion and improper treatment of patients. We report an interesting case of a 35-year-old male with a clinical history of chronic myelogenous leukemia post allogeneic peripheral blood stem cell transplantation and complete molecular remission, who was found to have chloroma of the left testis.

並列關鍵字

chloroma ； granulocytic sarcoma ； chronic myelogenous leukemia ； testis