PMC5536879_01
(A). FDG-PET detection of multiple metabolically active lesions on soft tissues on right and left shoulder, chest wall, back, epigastric region and legs (arrows). (B). FGD post induction and consolidation chemotherapy showing persistence of one metabolic active subcutaneous lesion on left arm (arrow).
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Furthermore, a FDG-PET detected multiple metabolically active lesions in soft tissues (SUV max 4.5) on right and left shoulder, chest wall, back, epigastric region and legs (Fig. 1). Ara-C, obtaining complete morphologic and immunophenotypic remission with typical features of PMF, clinical disappearance of subcutaneous nodules, but persistence of FDG-PET pathological uptake on both arms. As the pathological uptake on the right arm was in the area of a previous venous access (Fig. 1), we decided to perform radiotherapy (RT) on the contralateral arm.
(A-B). Excisional biopsy of a cutaneous lesion revealing the presence of a diffuse infiltration of proliferating elements with a blastic habit, involving also the subcutaneous fat and muscle tissues. (C). Immunohistochemistry showing that the majority of proliferating cells expressed CD34 antigen. (D). Immunohistochemical positivity of NPM1 with nuclear dislocation.
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Immunohistochemical positivity of NPM1 with nuclear dislocation was also present, whereas FLT3 mutations were not found (Fig. 2).