doiSerbia

Granulocytic sarcoma of the brain in a patient with acute myeloid leukemia

Čolović Nataša (Institute of Hematology, Clinical Center of Serbia, Belgrade)
Čolović Milica R. (Institute of Hematology, Clinical Center of Serbia, Belgrade)
Čemerikić-Martinović Vesna (Institute of Hematology, Clinical Center of Serbia, Belgrade)
Terzić Tatjana T. (Institute of Pathology, School of Medicine, Belgrade)
Ivanović Svetlana (Institute of Neurosurgery, Clinical Center of Serbia, Belgrade)
Skender-Gazibara Milica (Institute of Pathology, School of Medicine, Belgrade)
Bošković Darinka V. (Institute of Hematology, Clinical Center of Serbia, Belgrade)

Granulocytic sarcoma is extramedullary tumor composed of immature leukemic cells most frequently located in close proximity to bone, but it also can be found in the skin, breast, gastrointesti- nal tract, ovaries and brain. Granulocytic sarco- ma may arise during the course of leukemia or precede its development in the bone marrow. The majority of reported cases of granulocytic sarcomas in acute myleoid leukemia have chromosome translocation t(8;21). We report a 46-year-old man with acute myeloid leukemia, type M2 involving the marrow and peripheral blood and chromosome t(8;21) who developed granulocytic sarcoma in the brain, as a first manifestation of relapse 6 months after complete remission was achieved. During a neurosurgical operation a cortically located tumor (3.5x5 cm) in the brain was partially removed. Histology showed tumor consisted of homogenous infiltrate of blasts, admixed with more mature haematopoietic cells. The blasts have large round to oval nuclei, delicate chromatin, one or more small well-defined nucleoli and scant basophilic cytoplasm. Immunohistochemistry showed that blast cells were myeloperoxidase positive, confirming the diagnosis of myeloblastic sarcoma in the brain. The patient died two days after surgery.

Keywords: granulocytic sarcoma, brain