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<p>A 7-year-old boy with known rhabdomyosarcoma presented with anemia and bone marrow infiltration by pleomorphic non-hematopoietic cells mimicking acute leukemia. Morphologic evaluation revealed marked cellular heterogeneity, including multinucleation and clustering, with partial preservation of hematopoiesis. Immunohistochemistry showed positivity for Desmin, Myogenin, and MyoD1, confirming skeletal muscle differentiation, while CD45 was negative. These findings established bone marrow metastasis. This case highlights the diagnostic challenge of distinguishing metastatic rhabdomyosarcoma from leukemia and underscores the importance of integrated morphologic and immunohistochemical assessment.</p>

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Rhabdomyosarcoma Involving the Bone Marrow with Marked Non-Hematopoietic Cellular Heterogeneity

  • 期刊论文

  • 发表日期：

    2026年5月4日

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  • Yehezkiel Yonathan,
  • Ratu Purwanti

摘要

A 7-year-old boy with known rhabdomyosarcoma presented with anemia and bone marrow infiltration by pleomorphic non-hematopoietic cells mimicking acute leukemia. Morphologic evaluation revealed marked cellular heterogeneity, including multinucleation and clustering, with partial preservation of hematopoiesis. Immunohistochemistry showed positivity for Desmin, Myogenin, and MyoD1, confirming skeletal muscle differentiation, while CD45 was negative. These findings established bone marrow metastasis. This case highlights the diagnostic challenge of distinguishing metastatic rhabdomyosarcoma from leukemia and underscores the importance of integrated morphologic and immunohistochemical assessment.