Abstract
This paper describes a case of extramedullary tumor-forming chronic myelogenous leukemia in blast crisis. A 16-year-old boy with the chief complaint of anemia and abdominal mass was seen at our hospital and was diagnosed as chronic myelogenous leukemia. After one year of chronic phase, lymphoid blast crisis occurred in this patient. Although the patient achieved complete remission with VP therapy, he had the CNS relapse 6 months thereafter and the testicular relapse 9 months later, at which time radiation on the skull and testis was performed. Four months later, the patient began complaining about lowered visual acuity and pain in the right knee joint. Roentgenography disclosed the presence of tumors in the occipital region and in the femur. The tumor was resected from the femur, and cytochemical, immunological, and ultrastructural studies of the tumor tissues for tumor marker analysis resulted in the findings that the tumor cells were comprised of the two distinct cell populations of myeloid and T-lymphoid blast cells. Myeloid crisis resistant to the multidrug chemotherapy occurred in the bone marrow 7 months after onset of the tumor, and the patient died from the complication of bleeding in the lung. The cellular composition of the extramedullary tumor in this patient led us to presume that the lymphoid blast cells accumulated first in the tumor area, followed by myeloid blast cells to form the mixed composition in the tumor structure.
