ABSTRACT
Objective To investigate the clinical and pathological features,diagnosis and differential diagnosis of isolated granulocytic sarcoma of the ovary. Methods The clinical manifestations,pathological features,immunohistochemistry,treatment and prognosis were analyzed in 1 case of isolated granulocytic sarcoma of the bilateral ovary with the review of literatures. Results Granulocytic sarcoma of the ovary was rare. Only 14 cases had been reported so far. This case presented a greenish masse arising from the right ovary measuring 10.0 cm × 8.5 cm × 6.0 cm and 4.8 cm × 3.0 cm × 2.2 cm mass in the left ovary. The neoplastic cells grew in a diffuse pattern or India file, composed of myeloid cells at various stages of maturation, being predominantly primitive myelocytes with a few immature eosinophils. Immunohistochemistry,tumor cells were strongly positive for MPO,CD117,CD43,but negative for CD79α,CD3 Conclusions In routine morpholog,granulocytic sarcoma may be misinterpreted as lymphoma,granular cell tumor,et al. Neoplastic cells at various stages of maturation,India file pattern and immature eosinophils are important diagnostic clues. Immunohistochemical stains are essential in order to obtain correct diagnosis. Despite the localized nature of tumor, intensive antileukemia chemotherapy is necessary.
ABSTRACT
The granulocytic sarcoma is a rare tumor and occurs primarily in patients with acute myelogenous leukemia (AML). The granulocytic sarcoma can arise before, concurrent with, or following acute myeloid leukemia. This tumor can be rarely represented as the initial presentation of acute myeloid leukemia without any signs or symptoms of leukemia. Granulocytic sarcoma, rarely, can also occur in unexpected regions, including the head and neck. This tumor is very often misdiagnosed as a malignant lymphoma which leads to inappropriate treatment and poor outcome. Therefore, clinical, histopathological and immumohistochemical findings should be evaluated before any diagnosis of malignant lymphoma. We report, with a brief review of literature, a case of granulocytic sarcoma presenting as a head and neck neoplasm.
Subject(s)
Humans , Diagnosis , Head , Leukemia , Leukemia, Myeloid, Acute , Lymphoma , Neck , Sarcoma, MyeloidABSTRACT
Granulocytic sarcoma (GS) is an extramedullary tumor composed of immature myeloid cells, typically occurring during the course of acute myelogenous leukemia. Non-leukemic GS, that is, GS with no evidence of overt leukemia and no previous history of leukemia, is very rare, and even more unusual is nonleukemic GS of the bile duct. We report a case of nonleukemic GS of the bile duct. The patient was initially misdiagnosed as a bile duct carcinoma arising in the hilum of the liver (so-called Klatskin tumor), and received a right lobectomy of the liver. Histological examination of the tumor yielded the diagnosis of GS, and the bone marrow biopsy did not show any evidence of leukemia. Considering the risk of subsequent development of overt leukemia, the patient was treated with two cycles of combination chemotherapy as used in the cases of acute myelogenous leukemia. To date, he has remained free of disease 15 months after treatment.
Subject(s)
Male , Humans , Adult , Tomography, X-Ray Computed/methods , Sarcoma, Myeloid/diagnosis , Radiography, Abdominal , Peroxidase/analysis , Immunohistochemistry , Diagnosis, Differential , Bile Ducts/chemistry , Bile Duct Neoplasms/chemically induced , Leukocyte Common Antigens/analysisABSTRACT
Granulocytic sarcoma is a rare extramedullary tumor composed of myeloid progenitor cells. Primary involvement of the biliary tract without evidence of leukemia is exceedingly rare. Here, we report an isolated biliary granulocytic sarcoma in a 30-yr-old man who presented with jaundice, fever, and chill without any evidence of leukemia. However, five months after the diagnosis, he developed acute myelogenous leukemia with multilineage dysplasia and chromosomal abnormality. A rare possibility of biliary granulocytic sarcoma should be considered as a differential diagnosis in patients with obstructive jaundice. A histologic evaluation by aggressive diagnostic intervention is important and may improve prognosis.