Ann Dermatol.  2011 Oct;23(Suppl 2):S214-S217. 10.5021/ad.2011.23.S2.S214.

Primary Granulocytic Sarcoma of the Face

• Hwang JI
• Kim TY

• KMID: 2156793
• DOI: http://doi.org/10.5021/ad.2011.23.S2.S214

Abstract

Myeloid sarcoma is a tumor which consists of myeloblasts or immature myeloid cells. This tumor presents in the lymphoid organs, bone, skin, soft tissue, various mucosae and organs, and the central nervous system. Granulocytic sarcoma, an extramedullary acute myeloid leukemia, is also referred to as chloroma (GS) because of its greenish surface color. Granulocytic sarcoma is rare and difficult to diagnose. We can easily misdiagnose this tumor as lymphoma or sarcoma, especially when there is no evidence of hematologic disorders. Immunohistochemical studies are helpful in determining the correct diagnosis. Antibodies to myeloperoxidase, lysozyme, and chloroacetate esterase are used for the diagnosis of granulocytic sarcoma. In addition, detection of cell surface markers such as CD 33, CD 34, CD 68, CD 99, and HLA-DR may be useful. We describe a case of GS that presented with bluish nodules on the right cheek of a 54-year-old woman with immunohistochemical findings for correct diagnosis.

Keyword

Extramedullary acute myeloid leukemia; Immunohistochemistry; Myeloperoxidase

MeSH Terms

Antibodies
Carboxylic Ester Hydrolases
Central Nervous System
Cheek
Female
Granulocyte Precursor Cells
HLA-DR Antigens
Humans
Immunohistochemistry
Leukemia, Myeloid, Acute
Lymphoma
Middle Aged
Mucous Membrane
Muramidase
Myeloid Cells
Peroxidase
Sarcoma
Sarcoma, Myeloid
Skin
Antibodies
Carboxylic Ester Hydrolases
HLA-DR Antigens
Muramidase
Peroxidase
Sarcoma, Myeloid

Figure

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  Fig. 1 Several brownish to bluish nodules and plaque on the right cheek and temple.

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  Fig. 2 Photomicrograph of biopsy sections showing infiltration of immature myeloid cells to dermis (H&E: ×40, ×100, ×400).

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  Fig. 3 Positive staining for myeloperoxidase, CD 68 and CD 99 in granulocytic sarcoma cells of the skin (×400). MPO: myeloperoxidase.

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