Granulocytic sarcoma of breast: an aleukemic presentation

Area of Science:

• Oncology
• Hematology
• Pathology

Background:

• Granulocytic sarcoma is a rare extramedullary tumor of immature myeloid cells.
• It can occur independently of or in conjunction with hematologic malignancies.
• The breast is an unusual site for granulocytic sarcoma, necessitating a high index of suspicion.

Observation:

• A 45-year-old female presented with a non-tender left breast lump.
• Initial peripheral smear and bone marrow examinations were normal.
• Histopathological examination with immunohistochemistry confirmed granulocytic sarcoma.

Findings:

• Immunostains revealed myeloperoxidase, chloroacetate esterase, and CD43 positivity.
• The diagnosis was confirmed despite initial differential diagnoses of lobular carcinoma and non-Hodgkin's lymphoma.
• The patient later developed an orbital mass with bone marrow and peripheral smear involvement by acute myeloid leukemia (AML).

Implications:

• Early diagnosis and treatment of breast granulocytic sarcoma are crucial.
• Systemic chemotherapy similar to that for acute myeloid leukemia (AML) may be beneficial.
• Prompt treatment may delay or prevent the progression to overt AML.