A rare monocytic crisis of chronic myelogenous leukemia presenting with unusual extramedullary manifestations and an atypical (14;22)(q24;q11.2) translocation in the bone marrow

Abstract

A 48-year-old man was admitted due to marked leukocytosis. Bone marrow examinations resulted in a diagnosis of Philadelphia (Ph) chromosome-positive chronic myeloid leukemia. One month later, massive muscle and bone invasion by leukemic cells was detected. After induction chemotherapy, he complained of a headache and visual loss, which was caused by a leukemic infiltration in the central nervous system. After temporary remission in response to chemotherapy, the disease relapsed in the form of an intracranial tumor. The unusual t(14;22)(q24;q11.2) translocation of the Ph-chromosome and the significant increase in mono-cytes observed might have contributed to the unique and aggressive clinical course.