J Breast Cancer.  2013 Mar;16(1):112-116.

Granulocytic Sarcoma in Breast after Bone Marrow Transplantation

• Kim SJ
• Hong WS
• Jun SH
• Jeong SH
• Kang SY
• Kim TH
• Kang DK
• Yim HE
• Jung YS
• Kim KS

Abstract

Granulocytic sarcoma is a localized extramedullary solid tumor composed of immature myeloid cell and is usually associated with acute myeloid leukemia or myelodysplastic syndrome. Although it can involve any site, commonly in lymph nodes, skin, bone and soft tissue, the involvement of breast is unusual. Especially, the involvement of the breast as a pattern of relapse after bone marrow transplantation is extremely rare. We have experienced 2 cases of granulocytic sarcoma after bone marrow transplantation. One case was a 39-year-old woman with right breast mass diagnosed with granulocytic sarcoma. She had received an unrelated bone marrow transplantation due to biphenotype acute leukemia 3 years before our presentation. Another case was a 48-year-old woman with acute myeloid leukemia, who was diagnosed with granulocytic sarcoma on both breasts 8 months after allogenic bone marrow transplantation. We also discuss the clinicopathologic features of granulocytic sarcoma in breast after bone marrow transplantation.

Keyword

Acute myeloid leukemia; Breast; Granulocytic sarcoma

MeSH Terms

Bone Marrow
Bone Marrow Transplantation
Breast
Female
Humans
Leukemia
Leukemia, Myeloid, Acute
Lymph Nodes
Myelodysplastic Syndromes
Myeloid Cells
Recurrence
Sarcoma, Myeloid
Skin

Figure

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  Figure 1 Case 1. Ultrasonographic images of right breast (A) and axilla (B). Heterogenous hypoechoic masses with multifocal cystic portion in entire right breast with right axillary lymphadenopathy were identified.

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  Figure 2 Case 2. Radiologic findings of the breast. (A, B) Mammograms show multiple various sized circumscribed and ill defined iso to hypodense masses at both breast (A, right craniocaudal view; B, left craniocaudal view). (C, D) Sonographic images show multiple heterogeneous hypoechoic masses with echogenic boundary at both breast (C, right; D, left). (E, F) Magnetic resonance imaging findings show multiple variable sized enhancing masses in both breasts (E) and most of them show internal necrotic portion (F).

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  Figure 3 (A) Microscopic finding of case 2 shows diffuse infiltration of myeloblast (H&E stain, ×200). (B) Neoplastic cells were immunoreactive (purple stained area) for myeloperoxidase (immunohistochemistry stain, ×400).

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