Ann Dermatol.  2011 Oct;23(Suppl 2):S270-S273. 10.5021/ad.2011.23.S2.S270.

Multiple Granulocytic Sarcomas in a Patient with Longstanding Complete Remission of Acute Myelogenous Leukemia

Affiliations
  • 1Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. jylee@catholic.ac.kr

Abstract

Granulocytic sarcoma is an extramedullary tumor composed of granulocytic precursor cells. It usually presents as a nodular mass in the course of acute myelogenous leukemia. Rarely, the tumor develops in non-hematological conditions or in a patient with complete remission from the acute myelogenous leukemia. In such cases, aleukemic granulocytic sarcoma can be a preceding sign of systemic leukemia or a first sign of hematologic relapse of leukemia. We present an unusual case of multiple granulocytic sarcomas developed in a patient with longstanding complete remission of acute myelogenous leukemia, who has not had bone marrow and peripheral blood involvement for a long time.

Keyword

Aleukemic leukemia cutis; AML M1; Granulocytic sarcoma

MeSH Terms

Bone Marrow
Granulocyte Precursor Cells
Humans
Leukemia
Leukemia, Myeloid, Acute
Recurrence
Sarcoma, Myeloid

Figure

  • Fig. 1 (A, B) Widespread well-demarcated variable-sized greenish firm cutaneous nodules over the face, trunk and extremities.

  • Fig. 2 (A) Dense cellular infiltrate among collagen bundles and in the perifollicular areas within the entire dermis (H&E, original magnification ×40). (B) Higher magnification reveals homogenous atypical cells with round to oval shaped hyperchromatic nuclei (H&E, original magnification ×400).

  • Fig. 3 (A) Tumor cells are positive for Leder stain and immunoperoxidase (original magnification ×400). (B) Tumor cells are negative for CD3, CD20, CD34, TdT and Pax-5 (original magnification ×40).


Reference

1. Neiman RS, Barcos M, Berard C, Bonner H, Mann R, Rydell RE, et al. Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer. 1981. 48:1426–1437.
Article
2. Wiernik PH, Serpick AA. Granulocytic sarcoma (chloroma). Blood. 1970. 35:361–369.
Article
3. Duguid JK, Mackie MJ, McVerry BA. Skin infiltration associated with chronic myelomonocytic leukaemia. Br J Haematol. 1983. 53:257–264.
Article
4. Murakami Y, Nagae S, Matsuishi E, Irie K, Furue M. A case of CD56+ cutaneous aleukaemic granulocytic sarcoma with myelodysplastic syndrome. Br J Dermatol. 2000. 143:587–590.
Article
5. de Arruda Câmara VM, Morais JC, Portugal R, da Silva Carneiro SC, Ramos-e-Silva M. Cutaneous granulocytic sarcoma in myelodysplastic syndrome. J Cutan Pathol. 2008. 35:876–879.
Article
6. Long JC, Mihm MC. Multiple granulocytic tumors of the skin: report of six cases of myelogenous leukemia with initial manifestations in the skin. Cancer. 1977. 39:2004–2016.
Article
7. Firat F, Ozen G, Yildiz G, Sağlam A, Onder S, Tan E, et al. Late relapse of acute myeloblastic leukemia as myeloid sarcoma causing radiculopathy. Leuk Res. 2010. 34:e348–e350.
8. Byrd JC, Weiss RB. Recurrent granulocytic sarcoma. An unusual variation of acute myelogenous leukemia associated with 8;21 chromosomal translocation and blast expression of the neural cell adhesion molecule. Cancer. 1994. 73:2107–2112.
Article
9. Harris DW, Ostlere LS, Rustin MH. Cutaneous granulocytic sarcoma (chloroma) presenting as the first sign of relapse following autologous bone marrow transplantation for acute myeloid leukaemia. Br J Dermatol. 1992. 127:182–184.
Article
10. Orlandi E, Morra E, Lazzarino M, Castagnola C, Paulli M, Rosso R, et al. Multiple granulocytic sarcoma during complete hematologic remission of acute nonlymphoid leukemia. Acta Haematol. 1989. 81:41–43.
Article
11. Mason TE, Demaree RS Jr, Margolis CI. Granulocytic sarcoma (chloroma), two years preceding myelogenous leukemia. Cancer. 1973. 31:423–432.
Article
12. Takahashi T, Tsukuda H, Kimura H, Yoshimoto M, Tsujisaki M. Extramedullary relapse of AML with t(9;11)(p22;q23) associated with clonal evolution from trisomy 8 into tetrasomy 8. Intern Med. 2010. 49:447–451.
Article
13. Cho-Vega JH, Medeiros LJ, Prieto VG, Vega F. Leukemia cutis. Am J Clin Pathol. 2008. 129:130–142.
Article
14. Cronin DM, George TI, Sundram UN. An updated approach to the diagnosis of myeloid leukemia cutis. Am J Clin Pathol. 2009. 132:101–110.
Article
15. Imrie KR, Kovacs MJ, Selby D, Lipton J, Patterson BJ, Pantalony D, et al. Isolated chloroma: the effect of early antileukemic therapy. Ann Intern Med. 1995. 123:351–353.
Article
16. Yamauchi K, Yasuda M. Comparison in treatments of nonleukemic granulocytic sarcoma: report of two cases and a review of 72 cases in the literature. Cancer. 2002. 94:1739–1746.
Article
17. Krause JR. Granulocytic sarcoma preceding acute leukemia: a report of six cases. Cancer. 1979. 44:1017–1021.
Article
Full Text Links
  • AD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr