Lymph nodes - not lymphoma
Neoplasms (not lymphoma)
Acute myeloid leukemia / granulocytic sarcoma

Author: William D. DePond, M.D. (see Authors page)

Revised: 27 June 2018, last major update June 2006

Copyright: (c) 2003-2018, PathologyOutlines.com, Inc.

PubMed Search: Acute myeloid leukemia granulocytic sarcoma[TIAB] lymph node

See also: Leukemia chapter
Cite this page: DePond, W.D. Acute myeloid leukemia / granulocytic sarcoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodesAML.html. Accessed August 17th, 2018.
Definition / general
  • Also called granulocytic / myeloid sarcoma or chloroma when it forms a mass
  • Diagnosis requires a high degree of suspicion; thin sections are needed to see cytoplasmic granules
  • Lymphadenopathy may be initial presentation, preceding marrow involvement by months or years
  • May present with nodal infarction (Am J Surg Pathol 1989;13:177)
Case reports
Gross description
  • May have green hue ("chloroma") due to myeloperoxidase, which fades on exposure to air
Gross images

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Contributed by Dr. Mark R. Wick:

Granulocytic sarcoma



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Retroperitoneal lymphadenopathy

Subcutaneous tumor

Microscopic (histologic) description
  • Cortical or sinusoidal expansion by atypical cells with preservation of follicular centers
  • Blasts are large to medium size with distinct cytoplasmic borders and fine cytoplasmic granules
  • Nuclei have round, folded or lobated nuclei, fine and dispersed chromatin and small to prominent nucleoli
  • Often infiltrate in a single file pattern due to tumor cells insinuating between collagen fibers
  • Often associated with eosinophilic myelocytes
  • Auer rods may be present (Giemsa stain)
  • Variable mitotic figures
  • May have associated prominent sclerosis
Microscopic (histologic) images

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Granulocytic sarcoma

Acute myeloid leukemia

Involving liver

With interspersed eosinophilic myelocytes

Cytology description
  • Cytoplasmic granules in many cells
Cytology images

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Cytologic spectrum

Positive stains
(On blasts, not other inflammatory cells)
Electron microscopy description
  • Large electron dense primary cytoplasmic granules and less dense secondary granules
  • May have ellipsoidal crystalloid granules