Polyserositis as a primary clinical manifestation of CD7+acute myelogenous leukemia with myeloid sarcoma A case report

Rationale: Myeloid sarcomas (MS) are defined as rare extramedullary masses composed of immature myeloid cells. MS mostly develops in patients with acute myeloid leukemia (AML), and involves primarily the skin, soft tissues, bones, and lymph nodes. Pleura and pericardium involvement of MS are extremely uncommon. Polyserositis is also a very rare extramedullary presentation of acute myeloid leukemia (AML). Patient concerns: A 30-year-old woman with a complaint of right neck mass combined with coughing for 2 months as well as fever and systemic edema for the last 10 days, was admitted to our center on July 11, 2019. Initial positron emission tomography (PET) scan indicated systemic lymphadenopathy, bilateral pleural effusion, and pericardial effusion. Diagnosis: The initial pathological diagnosis of lymph nodes was MS. Subsequent bone marrow analysis confirmed AML. Interventions: Conventional IA induction regimen followed by high-dose cytarabine (HiDAC) regimen. Outcomes: Complete absorption of pericardial and pleural effusion after the first cycle of IA induction chemotherapy. Lessons: Polyserositis can be an extramedullary presentation of AML. Patients with polyserositis should undergo routine flow cytometric analysis. For AML with extamedullary infiltration, systemic chemotherapy should be administered in all confirmed cases.