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Granulocytic sarcoma presenting with lymph node infarction at disease onset: Report of two cases

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Kojima M, Nakamura S, Shimizu K, Yamane Y, Itoh H, Masawa N. Granulocytic sarcoma presenting with lymph node infarction at disease onset. Report of two cases. APMIS 2003;111:1133–6.

A completely infarcted lymph node is an unusual event. However, lymph node infarction should alert the pathologist to the considerable likelihood of malignant lymphoma. We report two unusual cases of acute myeloid leukemia presenting with granulocytic sarcoma at disease onset with a lymph node lesion exhibiting extensive lymph node infarction. The infarcted tissue contained numerous eosinophilic cell ghosts. There were some islands of degenerated, pyknotic medium-sized nuclei resembling lymphoblasts present in the necrotic area. By immunohistochemistry, these medium sized cells were CD3−, CD20−, CD34+, CD43+, CD45RO−, CD68−, CD79a− and myeloperoxidase+ in both cases. Differentiation of granulocytic sarcoma from malignant lymphomas is important for adequate therapy. The present cases indicate that granulocytic sarcoma should be added to the list of differential diagnoses for lymph node infarction.

Keywords: Acute myeloid leukemia; granulocytic sarcoma; immunohistochemistry; infarction; lymph node

Document Type: Research Article


Affiliations: 1: Pathology and Genetics, Aichi Cancer Center Hospital, Nagoya, 2: Pathology and Clinical Laboratories, Ashikaga Red Cross Hospital, Ashikaga, and 3: Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, 4: Pathology and Clinical Laboratories, Maebashi Red Cross Hospital, Maebashi, Japan 5: Pathology, Dokkyo University School of Medicine, Mibu,

Publication date: December 1, 2003

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