Hematolymphoid Malignancies with Neurological Manifestations and Hand-mirror cells in Peripheral Blood: A Report of two cases
Abstract
Hematolymphoid malignancies(HLM) can present with clinical features of systemic involvement and show hand-mirror cells(HMCs) in peripheral blood.
Two-patients presented with back pain and lower-limb weakness, blood smears revealed atypical cells, HMCs and thrombocytopenia. Imaging studies showed extradural spinal lesions. Histopathology of laminectomy specimens revealed myeloid sarcoma and diffuse B-cell lymphoma.
HMCs can be seen in malignant and non-malignant conditions. Presence of HMCs may be the initial finding in peripheral blood indicating underlying malignancy with or without generalized symptomatology and leucocytosis. This study aims to emphasize that presence of HMCs should prompt appropriate investigations and management after ruling out reactive conditions.
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References
2) Sakata H, Nakao A, Matsuda K, Yoshie N, Yamada T, Osako T et al. Acute leukemia presenting as bone pain with normal white blood cell count. Acute Med Surg. 2014 May 19;1(4):249. doi: 10.1002/ams2.46. PMID: 29930859; PMCID: PMC5997232.
3) Jellinger K, Radiaszkiewicz T. Involvement of the central nervous system in malignant lymphomas. Virchows Arch A Pathol Anat Histol. 1976 Jul 21;370(4):345-62. doi: 10.1007/BF00445779. PMID: 826017.
4) Storck K, Brandstetter M, Keller U, Knopf A. Clinical presentation and characteristics of lymphoma in the head and neck region. Head Face Med. 2019 Jan 3;15(1):1. doi: 10.1186/s13005-018-0186-0. PMID: 30606206; PMCID: PMC6317257.
5) Gall EA, Mallory TB. Malignant Lymphoma: A Clinico-Pathologic Survey of 618 Cases. Am J Pathol. 1942 May;18(3):381-429. PMID: 19970634; PMCID: PMC2032954.
6) Pandey S, Gokden M, Kazemi NJ, Post GR. Hematolymphoid Malignancies Presenting with Spinal Epidural Mass and Spinal Cord Compression: A Case Series with Rare Entities. Ann Clin Lab Sci. 2019 Nov;49(6):818-828. PMID: 31882434.
7) Sun T, Weiss R. Hand-mirror variant of microgranular acute promyelocytic leukemia. Leukemia. 1991 Mar;5(3):266-9. PMID: 2013982.
8) Smith RE. Hand-mirror-cell variant of B-cell lymphoma with hypercalcemia. Arch Intern Med. 1986 Nov;146(11):2273-4. PMID: 3490835.
9) Anand M, Gulati HK, Joshi AR. Hand-mirror cell morphology of T-cell lymphoproliferative disorder presenting in pleural effusion with mediastinal widening. J Cancer Res Ther. 2011 Jul-Sep;7(3):389-90. doi: 10.4103/0973-1482.87032. PMID: 22044839.
10) Thomas WJ, Yasaka K, Strong DM, Woodruff CM, Stass SA, Schumacher HR. Hand-mirror lymphocytes in infectious mononucleosis. Blood. 1980 Jun;55(6):925-30. PMID: 7378582.
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