Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 11-12, Pages: 805-808
https://doi.org/10.2298/SARH1112805C
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Granulocytic sarcoma of the femur in a patient with acute megakaryoblastic leukaemia
Čolović Nataša (Klinika za hematologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Bogdanović Andrija (Klinika za hematologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Vidović Ana (Klinika za hematologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Peruničić-Jovanović Maja (Klinika za hematologiju, Klinički centar Srbije, Beograd)
Čolović Milica (Klinika za hematologiju, Klinički centar Srbije, Beograd + Medicinski fakultet, Beograd)
Introduction. Granulocytic sarcoma, chloroma or myeloblastoma are observed in
3% to7% of acute myeloid leukaemia and represents localized tumour composed
of collection of immature leukaemic cells. It appears most frequently in
patients with M2, M4 and M5 subtypes of acute myeloid leukaemia Case Outline.
A 58-year-old female presented with pain and oedema of the right upper limb
in November 2009. After two months the patinet had fracture dislocation and
numerous osteolytic lesions of the right femur. Immunohistochemistry of
tumour biopsy showed megakaryoblastic granulocytic sarcoma which was CD31++,
F-XIII++, CD34-, FVIII+++, S100-, aktin-, EMA++, Bcl2++, CD43++, with
positive proliferative marker measured with Ki-67 positivity in more of 50%
of cells. Aspirate of bone marrow and immunophenotyping with flowcytometry
revealed diagnosis of acute megakaryoblastic leukaemia. The course of the
disease was rapid and the patient died before commencing chemotherapy, five
months after first complaints. Conclusion. Granulocytic sarcoma is
extramedullary localization of collection of leukaemia cells which can
proceed, to arise concomitantly with leukaemia, or may be the only
manifestation of the disease. The diagnosis can be established only with
immunohystochemistry.
Keywords: granulocytic sarcoma, megakaryoblastic leukaemia, immunohystochemistry