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Relapsed Acute Myeloid Leukemia Presenting as Multiple Breast Masses: A Case Report

유방의 다발성 결절로 발현한 급성 골수성 백혈병 재발의 건: 증례 보고

  • Pamela Sung (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • Jong Yoon Lee (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center) ;
  • A Jung Chu (Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center)
  • 성지연 (서울특별시 보라매병원 영상의학과) ;
  • 이종윤 (서울특별시 보라매병원 영상의학과) ;
  • 추아정 (서울특별시 보라매병원 영상의학과)
  • Received : 2022.04.30
  • Accepted : 2022.07.11
  • Published : 2023.03.01

Abstract

Hematologic malignancy of the breast is very rare. Here, we report a case of relapsed acute myeloid leukemia (AML) presenting as multiple breast masses. A 77-year-old female visited an outpatient clinic reporting palpable masses in both breasts. She had a medical history of AML, which showed complete remission after nine cycles of chemotherapy. On mammography and ultrasonography, there were multiple masses correlated with her palpable symptoms accompanied by enlarged lymph nodes. Core needle biopsy immunohistochemistry (IHC) results indicated AML and blastic plasmacytoid dendritic cell neoplasm. AML was confirmed using bone marrow biopsy. Although very rare, when a patient with a history of hematologic malignancy presents a palpable mass in the breast, clinicians should conduct proper tissue analysis, including IHC stating for leukemic markers, to guide appropriate diagnosis and treatment.

유방을 침범하는 혈액종양은 굉장히 드물게 보고되었다. 우리는 유방의 다발성 결절로써 재발한 급성 골수성 백혈병의 증례를 보고하고자 한다. 77세 여자 환자가 양측 유방의 촉지되는 다발성 결절로 외래를 내원하였다. 환자는 급성 골수성 백혈병(acute myeloid leukemia; 이하 AML)으로 진단받고 9차례의 항암치료 이후 완전 관해가 된 병력이 있었다. 유방 촬영과 유방 초음파에서 환자의 촉지성 병변이 영상의학적으로 확인되었으며 액와부 림프절 종대도 동반되었다. 총생검으로 얻은 검체는 면역화학염색을 통해 AML과 blastic plasmacytoid dendritic cell neoplasm의 형태를 보였으며 추후 진행한 골수 생검에서 AML로 확인되었다. 이렇듯 굉장히 드물지만, 혈액암의 병력을 가진 환자가 유방의 촉지성 종괴로 내원하였다면 담당의는 적절한 조직검사 및 면역화학검사로 정확한 진단을 하여 환자가 적절한 치료를 받도록 해야 한다.

Keywords

References

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