case_images: PMC4707376_01
case_images: EKG with T-wave inversions in the lateral leads V3-V5 as denoted by arrows.
case_images: CRIHEM2015-186869.001.jpg
case_images: PMC4707376_01_CRIHEM2015-186869.001.jpg
case_images: fig1
case_images: He was noted to have EKG changes with T-wave inversions in leads V3-V5 (Figure 1).
case_images: Chest CT with circumferential pericardial and nodular soft tissue densities posterior to the heart as denoted by red arrows.
case_images: CRIHEM2015-186869.002.jpg
case_images: PMC4707376_01_CRIHEM2015-186869.002.jpg
case_images: fig2
case_images: A high resolution CT scan of the chest revealed small circumferential pericardial and nodular soft tissue densities posterior to the heart, considered suspicious for metastatic deposits (Figure 2).
case_images: (a) H&E, low power. (b) H&E, high power. (c) Myeloperoxidase focal positivity. (d) CD43 commonly expressed in myeloid sarcoma. (e) CD34 (marker of immaturity). (f) CD117 focal+ (expressed in immature myeloid cells). (g) CD68 weak+ (monocytic/histiocytic markers). (h) CD163 focal+ (monocytic/histiocytic marker).
case_images: CRIHEM2015-186869.003.jpg
case_images: PMC4707376_01_CRIHEM2015-186869.003.jpg
case_images: fig3
case_images: By immunohistochemistry, the atypical cells showed an immature myeloid/monocytic immunophenotype: CD34 focal+, CD43+, MPO focal+, CD117 focal+, CD68 weak+, CD163 focal+, PAX5-, CD56-, TdT-, and CD79a focal weak+ (Figure 3).