CHLOROMA
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Features
Type of AML
Presents as solid tumor from localized proliferation of malignant myeloblasts
Seen in 2-14% AML -
Pathology
Green appearance due to MPO expression
Associated with MAL t8:21 translocation -
Clinical features:
Localized, usually in bone, periosteum, soft tissues, lymph nodes or skin
Sites: Orbit, paranasal sinus, GIT, genitourinary tract, breast, cervix, salivary glands, mediastinum, pleura, peritoneum, bile duct -
Diagnosis:
Presence of eosinophilic myelocytes in hematoxylin and eosin stained biopsy sections
Auer rods detection
Myeloid origin confirmed by cytochemical or immunohistochemical methods
Biopsy must be done with special immunohistochemical staining for myeloid markers, FISH, cytogenetics for AML related alterations
Flow immunophenotyping -
Treatment:
Intensive AML directed chemotherapy
Radiation therapy for non responsive cases