DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20163816

Rare case of a granulocytic sarcoma: cytological evaluation

Jayawant Mahadani, Pratik Chide, Sanjay Khandekar, Hitendra Khandekar, Nilima Lodha, Vaman Raut, Snehalata Hingway

Abstract


Granulocytic sarcomas (chloromas) are rare extramedullary tumors consisting of primitive granulocytic cells. They arise de novo, or are associated with other hematologic disorders such as acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative disorders. We report here a case of a 33-year-old man who presented with extensive skin lesions all over body, including face region. The patient is a known case of chronic myeloid Leukemia (CML). Fine needle aspiration cytology (FNAC) of skin lesion was suggestive of granulocytic sarcoma. Histological evaluation of skin biopsy revealed infiltration by atypical myeloid cells. Peripheral blood smear (PBS) examination was within normal limit. Immunohistochemistry (IHC) confirmed the diagnosis of Granulocytic sarcoma. Here we present a case of granulocytic sarcoma which was suspected on FNAC findings and which was confirmed on histochemistry and immunohistochemistry. These cases illustrate the utility of FNAC in diagnosis of granulocytic sarcoma.


Keywords


Chronic myeloid leukemia, Fine needle aspiration cytology, Granulocytic sarcoma

Full Text:

PDF

References


Jenkins CI, Sorour Y. Case Report: A Large Extramedullary Granulocytic Sarcoma as the Initial Presenting Feature of Chronic Myeloid Leukemia. MedGenMed. 2005;7:23.

Campidelli C, Agostinelli C, Stitson R, Pileri SA. Myeloid Sarcoma- Extramedullary Manifestation of Myeloid Disorders. Am J Clin Pathol. 2009;132:426-7.

Kumar PV: Soft tissue chloroma diagnosed by fine needle aspiration cytology. A case report. Acta Cytol. 1994;38:83-6.

Pettinato G, De Chiara A, Insabato L, De Ren-zo A. Fine needle aspiration biopsy of a granulocytic sarcoma (chloroma) of the breast. Acta Cytol. 1998;32:67-71.

Dunphy CH, Katz RL, Fanning CV, Dalton WT. Leukemic lymphadenopathy: Diagnosis by fine needle aspiration. Hematol Pathol. 1989;3:35-44.

Raab SS, Silverman JF, McLeod DL, Geisinger KR. Fine-needle aspiration cytology of extra-medullary hematopoiesis (myeloid metapla-sia). Diagn Cytopathol. 1993;9:522-9.

Jaffe ES, Harris NL, Stein H, Vardimann JW, editors. World Health Organisation Classification of Tumours-Tumours of Haematopoietic and Lymphoid Tissues. 2001:105.

Martel L, Reddy K, Greco M, Tuscano M, Richman M, Wun T. Isolated cavernous sinus extramedullary relapse of chronic myelogenous leukemia following allogeneic stem cell transplant. Ann Hematol. 2002;81:108-10.

Mahendra P, Ager S, Bedlow AJ, Bloxham DM, Green AR, Marcus RE. Two unusual neurological presentations of granulocytic sarcoma in Philadelphia positive chronic myeloid leukaemia. Leuk Lymphoma. 1994;15:351-5.

Druker BJ1, Talpaz M, Resta DJ, Peng B, Buchdunger E, Ford JM, et al. Efficacy and safety of a specific inhibitor of the BCR-ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med. 2001;344:1031-7.