Table of Contents
Definition / general | Sites | Clinical features | Radiology description | Prognostic factors | Case reports | Treatment | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Cytology images | Positive stains | Negative stains | Differential diagnosisCite this page: Gupta N. Granulocytic sarcoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorgranulocyticsarcoma.html. Accessed May 11th, 2021.
Definition / general
- Extramedullary tumor of malignant myeloid precursor cells (also called nonleukemic granulocytic sarcoma)
- Can arise de novo or be the sole manifestation of relapse
- Also called chloroma due to green color imparted by myeloperoxidase in myelogenous leukemic cells (Eur J Radiol 2012;81:472)
Sites
- Bone, periosteum, soft tissue, lymph node
- Less commonly orbit, intestine, mediastinum, epidural region, uterus, ovary (J Clin Oncol 30, 2012 (suppl; abstr e17011))
Clinical features
- 3 - 9% of patients with acute or chronic myelogenous leukemia (AJNR Am J Neuroradiol 1991;12:259)
- Abdominal mass and abdominal pain
Radiology description
- Mixed cystic and solid adnexal mass with intermediate signal intensity on T1 weighted images and hypointensity on T2 weighted images (Br J Radiol 1999;72:301)
Prognostic factors
- Poor prognosis if arises de novo compared to known cases of AML
Case reports
- 18 year old woman with aleukemic granulocytic sarcoma presenting at multiple sites (Rare Tumors 2012;4:e36)
- 26 year old woman with primary granulocytic sarcoma of ovary (Am J Clin Oncol 2000;23:239)
- 46 year old woman (Arch Pathol Lab Med 1991;115:830)
- 49 year old woman with primary ovarian granulocytic sarcoma (J Clin Oncol 30, 2012 (suppl; abstr e17011))
Treatment
- Surgery followed by induction chemotherapy (daunorubicin / cytosine arabinoside) followed by three cycles of consolidation chemotherapy (cytosine arabinoside)
Gross description
- Lobulated solid / cystic mass 5-10 cm
- Outer surface encapsulated and cut surface is tan grey with multiple small hemorrhagic and brownish areas
Gross images
AFIP images
Acute leukemia
Images hosted on other servers:
Lobulated solid mass of ovary
Microscopic (histologic) description
- Monomorphic population of small round cells diffusely infiltrating ovarian stroma
- Discohesive cells lying in sheets
- Cells have scant to moderate basophilic cytoplasm; are hyperchromatic, with high nuclear cytoplasmic ratio, coarse chromatin, conspicuous nucleoli
Microscopic (histologic) images
AFIP images
Thin cords
Images hosted on other servers:
H&E
Myeloperoxidase, CD45, alkaline phosphatase, vimentin
Cytology description
- Large round to oval cells with moderate pale blue cytoplasm, high nuclear / cytoplasmic ratio
- Nuclei are round to oval with 2-4 prominent nucleoli (blast cells)
- Few large monocytoid cells with prominent nucleoli
Cytology images
Images hosted on other servers:
FNA breast (fig 2C-2E)
Positive stains
Negative stains
Differential diagnosis
