Granulocytic sarcoma: misleading immunohistological staining with MT1 and S100 protein antibodies

Tissue from two patients with granulocytic sarcomas stained positively for MT1 and S100 protein antibodies; both of these cases presented considerable clinical and histological diagnostic difficulties until acute myeloblastic leukaemia spread to the bone marrow. Tissues from a further eight patients with granulocytic sarcoma were also examined retrospectively. Seven of them stained for MT1 and four for S100 protein but the traditional histological markers for myeloid cells--chloroacetate esterase and lysosyme--often stained only weakly and focally. This pattern of staining should raise the possibility of a granulocytic sarcoma in otherwise problematic cases.