Severe case of peripheral leukocytosis initially diagnosed as myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable, but possibly prefibrotic primary myelofibrosis

Seisuke Ota, Yasushi Hiramatsu, Eisei Kondo, Akinori Kasahara, Saimon Takada, Sachio Umena, Toshio Noguchi, Mitsune Tanimoto, Tadashi Matsumura

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Leukocytosis is occasionally seen in patients with presumptive but undiagnosed myeloproliferative disorders (MPD). A 74-year-old woman was admitted to our hospital for tarry stools, anemia, and marked peripheral leukocytosis of 1.4×105/μL. Gastroenteroscopy revealed an acute gastric and duodenal mucosal lesion that was treated successfully via endoscopic hemoclipping. Bone marrow aspiration revealed marked megakaryocyte proliferation with atypia of naked nuclei and marrow hypercellularity (90% cellularity). A fluorescence in situ hybridization test could not detect the BCR-ABL fusion gene. Bone marrow aspiration later revealed further abnormalities of megakaryocytes. The patient died from cerebral bleeding. The present case fulfilled 2 of the 3 major criteria of primary myelofibrosis according to the World Health Organization 2008 classification:namely, megakaryocytic hyperplasia with hypercellular marrow and granulocytic hyperplasia. However, the megakaryocytic abnormality was not strictly compatible with the criteria. Instead, we considered prefibrotic primary myelofibrosis as a possibility, although myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable (MDS/MPN-U) was technically the correct diagnosis. The present case shows that MPN diagnosis remains difficult and suggests that other cases of peripheral leukocytosis with diagnosed MDS/MPN-U might include similar findings.

Original languageEnglish
Pages (from-to)363-368
Number of pages6
JournalActa Medica Okayama
Volume68
Issue number6
Publication statusPublished - 2014

Fingerprint

Primary Myelofibrosis
Myelodysplastic Syndromes
Leukocytosis
Bone
Bone Marrow
Megakaryocytes
Hyperplasia
Neoplasms
Fusion reactions
Genes
Fluorescence
Health
Myeloproliferative Disorders
Gene Fusion
Fluorescence In Situ Hybridization
Anemia
Stomach
Hemorrhage

Keywords

  • Acute gastric mucosal lesion
  • Anemia
  • Leukocytosis
  • Multiple cerebral hemorrhages
  • Prefibrotic primary myelofibrosis

ASJC Scopus subject areas

  • Medicine(all)
  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Severe case of peripheral leukocytosis initially diagnosed as myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable, but possibly prefibrotic primary myelofibrosis. / Ota, Seisuke; Hiramatsu, Yasushi; Kondo, Eisei; Kasahara, Akinori; Takada, Saimon; Umena, Sachio; Noguchi, Toshio; Tanimoto, Mitsune; Matsumura, Tadashi.

In: Acta Medica Okayama, Vol. 68, No. 6, 2014, p. 363-368.

Research output: Contribution to journalArticle

Ota, S, Hiramatsu, Y, Kondo, E, Kasahara, A, Takada, S, Umena, S, Noguchi, T, Tanimoto, M & Matsumura, T 2014, 'Severe case of peripheral leukocytosis initially diagnosed as myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable, but possibly prefibrotic primary myelofibrosis', Acta Medica Okayama, vol. 68, no. 6, pp. 363-368.
Ota, Seisuke ; Hiramatsu, Yasushi ; Kondo, Eisei ; Kasahara, Akinori ; Takada, Saimon ; Umena, Sachio ; Noguchi, Toshio ; Tanimoto, Mitsune ; Matsumura, Tadashi. / Severe case of peripheral leukocytosis initially diagnosed as myelodysplastic syndrome/myeloproliferative neoplasm, unclassifiable, but possibly prefibrotic primary myelofibrosis. In: Acta Medica Okayama. 2014 ; Vol. 68, No. 6. pp. 363-368.
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