Acute myeloid leukemia / granulocytic sarcoma

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

Table of Contents

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

43 year old woman with chronic myelofibrosis progressing to AML M7 (Eur J Haematol 2001;67:194)

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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