Isolated Intracranial Myeloid Sarcoma Mimicking Malignant Lymphoma: A Diagnostic Challenge and Literature Reviews

Guixuan Xu,1,* Haijun Zhang,1,* Weixia Nong,2 Chunsen Li,1 Lian Meng,1 Chunxia Liu,1 Feng Li1,3 1Department of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, The First Affiliated Hospital, Shihezi University of Medical, Shihezi, 832002, People’s Republic of China; 2Department of Hematology, The First Affiliated Hospital of Medical College of Shihezi University, Shihezi 832002, People’s Republic of China; 3Department of Pathology and Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chunxia LiuDepartment of Pathology and Key Laboratories for Xinjiang Endemic and Ethnic Diseases, The First Affiliated Hospital,Shihezi University of Medical, North 2 Road, Shihezi, Xinjiang 832002 People’s Republic of ChinaEmail liuliu2239@sina.comFeng LiDepartment of Pathology and Medical Research Center, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing 100020, People’s Republic of ChinaEmail lifeng7855@126.comAbstract: Isolated intracranial myeloid sarcoma (MS) is an unusual variant tumor with few cases reported so far in the medical literature. A 29-year-old woman was admitted to our hospital presenting progressive visual loss in the right eye and weight loss (20 kg) without a previous history of hematological disease (HD). Radiologic evaluation showed the evidence of intracranial mass. Histologically, the resected tumor was composed of a uniform population of primitive cells and primarily misdiagnosed as a T-cell non-Hodgkin’s lymphoma (NHL). Chemotherapy with cyclophosphamide, doxorubicin, vinblastine, and prednisone (CHOP) was ineffective. A biopsy and histopathological evaluation were repeated, and immunohistochemical staining revealed the positivity of immature cells to an extensive panel of myeloid markers. These findings were consistent with a diagnosis of MS and bone marrow infiltration. Literature reviews of previous cases were also undertaken.Keywords: myeloid sarcoma, isolated, intracranial, non-Hodgkin’s lymphoma, misdiagnosis