Granulocytic sarcoma

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Granulocytic sarcoma is an uncommon malignant soft tissue lesion that really represents a hematologic malignancy; it is a soft tissue manifestation of acute myeloid leukemia. It is not a sarcoma.

Granulocytic sarcoma
Diagnosis in short

Chloroma. H&E stain.

Synonyms extramedullary leukemia, myeloid sarcoma and chloroma, myeloblastoma, chloromyeloma, chloromyelosarcoma, granulocytic leukosarcoma, myelosarcoma

LM atypical small blue cells ~2x resting lymphocyte, infiltrative
LM DDx small round cell tumours
Site soft tissue lesion

Prevalence rare
Clin. DDx other soft tissue lesions
Treatment see acute myeloid leukemia

Numerous other terms refer to this including extramedullary leukemia,[1] myeloid sarcoma and chloroma.

Less common terms include:[2] myeloblastoma, chloromyeloma, chloromyelosarcoma, granulocytic leukosarcoma, and myelosarcoma.

General

Microscopic

Features:

  • Cluster of atypical small blue cells in soft tissue with scant cytoplasm.

DDx:

Images

www:

IHC

Features:[3]

  • CD117 +ve (9 of 9 cases).
  • CD43 +ve (7 of 7 cases).
  • Myeloperoxidase +ve (8 of 10 cases).
  • CD34 +ve/-ve (5 of 9 cases).

Sign out

  • It is prudent to mention acute myeloid leukemia somewhere in the report to ensure the appropriate referral is made.

See also

References

  1. Bakst, RL.; Tallman, MS.; Douer, D.; Yahalom, J. (Oct 2011). "How I treat extramedullary acute myeloid leukemia.". Blood 118 (14): 3785-93. doi:10.1182/blood-2011-04-347229. PMID 21795742.
  2. 2.0 2.1 Eom, KS.; Kim, TY. (Mar 2011). "Intraparenchymal myeloid sarcoma and subsequent spinal myeloid sarcoma for acute myeloblastic leukemia.". J Korean Neurosurg Soc 49 (3): 171-4. doi:10.3340/jkns.2011.49.3.171. PMC 3085814. PMID 21556238. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3085814/.
  3. Seifert, RP.; Bulkeley, W.; Zhang, L.; Menes, M.; Bui, MM. (Aug 2014). "A practical approach to diagnose soft tissue myeloid sarcoma preceding or coinciding with acute myeloid leukemia.". Ann Diagn Pathol 18 (4): 253-60. doi:10.1016/j.anndiagpath.2014.06.001. PMID 24969631.