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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 206

Myeloid sarcoma of the joint: A rare presentation


Institute of Hematology & Transfusion Medicine, Medical College & Hospital, Kolkata 700 073, West Bengal, India

Date of Submission20-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Maitreyee Bhattacharyya
Institute of Hematology & Transfusion Medicine, Medical College & Hospital, Kolkata 700 073, West Bengal
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2328_19

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How to cite this article:
Jha K, Bhattacharyya M. Myeloid sarcoma of the joint: A rare presentation. Indian J Med Res 2020;152, Suppl S1:206

How to cite this URL:
Jha K, Bhattacharyya M. Myeloid sarcoma of the joint: A rare presentation. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:206. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/206/316827

The child's assent and parent's consent obtained to publish clinical information and images.


A 17 yr old female attended the Orthopaedics outpatient department (OPD) of the Medical College & Hospital, Kolkata, India, in April 2019, with progressive left elbow painful swelling and fever for the preceding one month [Figure 1]A. Her complete haemogram was within normal limits. Magnetic resonance imaging of the left elbow joint showed a large lesion involving the articular cartilage and synovium and infiltrating the joint cavity [Figure 1]B. Following no response to empirical antibiotics, fine-needle aspiration was done which showed atypical cells with blastoid morphology [Figure 1]C. The patient was referred to the Haematology OPD. On identifying  Auer rods More Details in the blastoid cells [Figure 1]C, bone marrow aspiration was done which showed 25 per cent of the blasts with myeloid immunophenotype. Diagnosed as acute myeloid leukaemia with myeloid sarcoma of the joint, the patient was treated with standard induction chemotherapy following which the joint swelling regressed. Myeloid sarcomas of joints are rare and in this case no blasts were observed in the peripheral blood. Fever with joint swelling not responding to antibiotics was the only clue for diagnosis.
Figure 1: (A) Photograph showing the left elbow swelling (arrow). (B) T2-weighted magnetic resonance image (coronal section) of the left elbow joint showing a large lesion impinging onto the articular surface and destruction of the joint along with the posterior subluxation of radius (arrow). (C) Fine-needle aspiration from the swelling showing blasts (LG, ×40); inset showing a blast with the Auer rods (arrow) (LG, ×100). LG, Leishman Giemsa stain.

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Acknowledgment: Authors acknowledge Dr Aniruddha Dey, department of Orthopedics, for referring the patient to the Hematology OPD for further diagnosis and management.

Conflicts of Interest: None.


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