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Granulocytic sarcoma presenting with lymph node infarction at disease onset.

Masaru Kojima1, Shigeo Nakamura, Kazuhiko Shimizu

  • 1Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan. mkojima@gunma-cc.jp

APMIS : Acta Pathologica, Microbiologica, Et Immunologica Scandinavica
|December 18, 2003
PubMed
Summary

Lymph node infarction is rare but can indicate lymphoma. This study highlights acute myeloid leukemia presenting as granulocytic sarcoma with extensive lymph node infarction, suggesting it as a differential diagnosis.

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Area of Science:

  • Pathology
  • Hematology
  • Oncology

Background:

  • Lymph node infarction is an uncommon finding in pathology.
  • It often suggests a high probability of malignant lymphoma.

Observation:

  • Two unusual cases of acute myeloid leukemia (AML) presented with granulocytic sarcoma at disease onset.
  • The lymph node lesions showed extensive infarction with eosinophilic cell ghosts and degenerated nuclei.

Findings:

  • Immunohistochemistry revealed medium-sized cells positive for CD34, CD43, and myeloperoxidase, but negative for lymphoid markers (CD3, CD20, CD79a).
  • These findings are characteristic of granulocytic sarcoma, not lymphoma.

Implications:

  • This study suggests granulocytic sarcoma should be included in the differential diagnosis of lymph node infarction.

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  • Accurate differentiation between granulocytic sarcoma and lymphoma is crucial for appropriate patient therapy.