From www.bloodjournal.org by guest on September 11, 2016. For personal use only.

bloodwork ®

IMAGES

IN HEMATOLOGY

Uveal melanoma with diffuse bone marrow involvement

c Sheng-Yen Hsiao, Taiwan National Institute of Cancer Research; and Tsai-Yun Chen, National Cheng Kung University Hospital

A

76-year-old man received left eye enucleation resulting from ablepsia in May 2013. A pathological review suggested a malignant melanoma of the choroid body with staging of T2b (panel A); white quadrangle in A, original magnification, 3200 (panel B). The patient visited an oncology outpatient department for persistent low back pain and asthenia for more than 1 month in September 2013. For malignant melanoma surveillance, unexpectedly, a whole-body 18F-fluorodeoxyglucose-positron emission tomography revealed increased 18 F-fluorodeoxyglucose uptake over the whole cervical-thoracic-lumbar spine, sacrum, pelvic bone, bilateral proximal femoral bone, and bilateral scapular bone (panel C). Liu’s stain of a peripheral blood smear revealed leukoerythroblastosis and circulating tumor cells with abundant cytoplasm and bizarre nucleus (panel D, arrow). Bone marrow study demonstrated nonhematopoietic cells with prominent nucleus arranged in clusters (panel E, arrow). Immunohistochemical analysis was positive for S-100 and human melanoma black 45, thus identified as metastatic melanoma. After confirmed diagnosis, the patient died of respiratory failure secondary to pneumonia 2 months later. Uveal melanoma with bone marrow involvement is very rare. However, similar clinical pictures have been reported in patients with cutaneous melanoma. An interesting finding of this case is the presentation as hematologic malignancy in positron emission tomography scan and blood smear. For additional images, visit the ASH IMAGE BANK, a reference and teaching tool that is continually updated with new atlas and case study images. For more information visit http://imagebank.hematology.org. © 2014 by The American Society of Hematology 1996

BLOOD, 18 SEPTEMBER 2014 x VOLUME 124, NUMBER 12

From www.bloodjournal.org by guest on September 11, 2016. For personal use only.

2014 124: 1996 doi:10.1182/blood-2014-05-573816

Uveal melanoma with diffuse bone marrow involvement Sheng-Yen Hsiao and Tsai-Yun Chen

Updated information and services can be found at: http://www.bloodjournal.org/content/124/12/1996.full.html Articles on similar topics can be found in the following Blood collections BloodWork (465 articles) Free Research Articles (4041 articles) Lymphoid Neoplasia (2370 articles) Information about reproducing this article in parts or in its entirety may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#repub_requests Information about ordering reprints may be found online at: http://www.bloodjournal.org/site/misc/rights.xhtml#reprints Information about subscriptions and ASH membership may be found online at: http://www.bloodjournal.org/site/subscriptions/index.xhtml

Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published weekly by the American Society of Hematology, 2021 L St, NW, Suite 900, Washington DC 20036. Copyright 2011 by The American Society of Hematology; all rights reserved.

Uveal melanoma with diffuse bone marrow involvement.

Uveal melanoma with diffuse bone marrow involvement. - PDF Download Free
861KB Sizes 3 Downloads 13 Views