Predicting lymph node metastasis in gastric adenocarcinoma: Role of tumor budding and immunohistochemical expression of E-cadherin

Background: Chronic myeloid leukaemia is a form of myeloproliferative neoplasm characterised by the proliferation of granulocytes. This particular form of myeloproliferative neoplasm is rare, accounting for approximately 2% – 3% of recently diagnosed pediatric leukaemia. Neuropsychological manifestation is a rare initial sign in patients with chronic myeloid leukaemia. Case presentation: A 10-year-old girl who presented with two weeks of abnormal behaviour. Her neurological assessment revealed no abnormality. Her serial full blood count revealed persistent leucocytosis, and her most recent full blood picture showed 2.3% blast cells. Following a comprehensive analysis of bone marrow smear and identification of the BCR-ABL fusion gene, it was concluded that the patient had chronic myeloid leukaemia in chronic-phase. Her neuropsychological symptoms improved after a few months of imatinib treatment, and she will be scheduled for a stem cell transplant if her human leukocyte antigen matches those of other siblings. Conclusion: Neuropsychological manifestations in chronic myeloid leukaemia-chronic phase are uncommon in children and can be mistaken for more prevalent conditions. Physicians should maintain a vigilant stance due to the distinct management and prognosis of chronic myeloid leukaemia in comparison to the more prevalent condition in paediatric.