Advertisement

International Journal of Hematology

, Volume 79, Issue 3, pp 250–252 | Cite as

Granulocytic sarcoma presenting with malignant anasarca in a patient with secondary acute myeloid leukemia

  • Mohammad Y. Khan
  • Khader K. Hussein
  • Max G. Walter
  • Muhammad K. Hasan
  • William Kern
  • Mohamed A. Kharfan-Dabajaa
Case Report

Abstract

Granulocytic sarcomas (GS) are rare extramedullary tumor masses composed of immature cells derived from the hematopoietic myeloid series. GS occur in 3% to 7% of cases of acute myeloid leukemia (AML) and can present before, during, or even after the diagnosis of AML. GS can involve different organs, individually or simultaneously, including the skin, lymph nodes, bone, breast, central nervous system, and lung among others. GS involving peritoneal and pleural fluids is a rare presentation. We present an unusual case of a patient with myelodysplastic syndrome whose disease progressed into a secondary AML and developed GS in the ascitic and pleural effusions as the predominant manifestation of disease progression.

Key words

Acute myeloid leukemia Ascites Chloromas Granulocytic sarcomas Myelodysplastic syndromes 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    King A. Case of chloroma. Monthly J Med Sci (Lond). 1853;7:97.Google Scholar
  2. 2.
    Neiman RS, Barcos M, Costan B, et al. Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer. 1981;48:1426–1437.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Rappaport H. Tumors of the hematopoietic system. In: Atlas of Tumor Pathology. Washington, DC: Armed Forces Institute of Pathology; 1966; sect III, fasc 8:241–243.Google Scholar
  4. 4.
    Liu PI, Ishimaru T, McGregor DH, Okada H, Steer A. Autopsy study of granulocytic sarcoma (chloroma) in patients with myelogenous leukemia, Hiroshima-Nagasaki 1949-1969. Cancer. 1973;31:948–955.CrossRefGoogle Scholar
  5. 5.
    Abe R, Umezu H, Uchida T, et al. Myeloblastoma with an 8;21 chromosome translocation in acute myeloblastic leukemia. Cancer. 1986;58:1260–1264.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Tallman MS, Hakimian D, Shaw JM, Lissner GS, Russell EJ, Variakojis D. Granulocytic sarcoma is associated with the 8;21 translocation in acute myeloid leukemia. J Clin Oncol. 1993;11:690–697.CrossRefGoogle Scholar
  7. 7.
    Swirsky DM, Li YS, Mathews JG, Flemans RJ, Rees JK, Hayhoe FG. 8,21 translocation in acute granulocytic leukaemia: cytological, cytochemical and clinical features. Br J Haematol. 1984;56:199–213.CrossRefPubMedGoogle Scholar
  8. 8.
    Menasce LP, Banerjee SS, Beckett E, Harris M. Extra-medullary myeloid tumour (granulocytic sarcoma) is often misdiagnosed: a study of 26 cases. Histopathology. 1999;34:391–398.CrossRefPubMedGoogle Scholar
  9. 9.
    Domingo-Domenech E, Boque C, Narvaez JA, Romagosa V, Domingo-Claros A, Granena A. Acute monocytic leukemia in the adult presenting with associated extramedullary gastric infiltration and ascites. Haematologica. 2000;85:875–877.PubMedGoogle Scholar
  10. 10.
    Simel DL, Weinberg JB. Leukemic ascites complicating acute myelomonoblastic leukemia. Arch Pathol Lab Med. 1985;109:365–367.PubMedGoogle Scholar
  11. 11.
    Heimann P, Vamos E, Ferster A, Sariban E. Granulocytic sarcoma showing chromosomal changes other than the t(8;21). Cancer Genet Cytogenet. 1994;74:59–61.CrossRefPubMedGoogle Scholar
  12. 12.
    Bown NP, Rowe D, Reid MM. Granulocytic sarcoma with translocation (9;11)(p22;q23): two cases. Cancer Genet Cytogenet. 1997;96:115–117.CrossRefPubMedGoogle Scholar
  13. 13.
    Cavdar AO, Bökesoy I, Sunguroglu A, et al. Orbito-ocular granulocytic sarcoma (OOGS) and acute myeloblastic leukemia (AML) with duplication of Philadelphia chromosome. Cancer Genet Cytogenet. 1993;69:38–40.CrossRefPubMedGoogle Scholar
  14. 14.
    Prolla JC, Kirsner JB. The gastrointestinal lesions and complications of the leukemias. Ann Intern Med. 1964;61:1084–1103.CrossRefPubMedGoogle Scholar
  15. 15.
    Rowlands CG. Cytology of ascitic fluid in a patient with granulocytic sarcoma (extramedullary myeloid tumor). A case report. Acta Cytol. 1999;43:227–231.CrossRefPubMedGoogle Scholar
  16. 16.
    Fiel I, Strauchen JA, LoValvo R, Meyer RJ, Unger PD. Acute granulocytic leukemia with ascites as the initial manifestation. Acta Cytol. 1995;39:608–609.PubMedGoogle Scholar
  17. 17.
    Raynolds AH, Olivetti RG, Ekstrand RW. A leukemic stem cell leukemia with polyserositis: report of case. Blood. 1955;10:81–86.PubMedGoogle Scholar
  18. 18.
    Nagasawa T, Tanoue K, Onozawa Y, Nakajima T, Abe T. A case of acute leukemia characterized by peritoneal leukemia developed during hematological remission. Jpn J Clin Hematol. 1974;15:790–794.Google Scholar

Copyright information

© The Japanese Society of Hematology 2004

Authors and Affiliations

  • Mohammad Y. Khan
    • 1
  • Khader K. Hussein
    • 2
  • Max G. Walter
    • 3
  • Muhammad K. Hasan
    • 4
  • William Kern
    • 5
  • Mohamed A. Kharfan-Dabajaa
    • 4
  1. 1.Section of Hematology-OncologyUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  2. 2.Cancer Care AssociatesOklahoma CityUSA
  3. 3.Departments of RadiologyUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  4. 4.Departments of Internal MedicineUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA
  5. 5.Departments of PathologyUniversity of Oklahoma Health Sciences CenterOklahoma CityUSA

Personalised recommendations