Granulocytic Sarcoma (Chloroma)

Abstract

Four patients with granulocytic sarcoma are described. Granulocytic sarcoma of the cheek occurred in one patient 10 months before the diagnosis of acute myelocytic leukemia could be made. Another patient had multiple bone and dural granulocytic sarcomas 17 months before she developed acute myelocytic leukemia. One patient had a breast granulocytic sarcoma and acute myelocytic leukemia diagnosis simultaneously, and a fourth patient developed a chest wall granulocytic sarcoma 11-½ months after the diagnosis of acute monocytic leukemia. The cheek and chest wall granulocytic sarcomas responded completely to antileukemic chemotherapy but subsequently recurred. Radiotherapy effected a permanent complete remission of the chest wall sarcoma, and partial regression of the bone granulocytic sarcomas in another case. The possibility that acute myelocytic leukemic, granulocytic sarcoma and reticulum cell sarcoma are variations of the same disease is suggested and discussed.

Bone marrow transplantation for myeloblastoma

“…This patient showed the rare constellation of myeloblastoma with lymph node, pleura, skin, and ureter involvement without evidence of AML. According to previous publications, myeloblastoma usually represents a manifestation of leukaemia accompanying or preceding the characteristic features of that disease (2,3). Little is known about its impact on therapy and prognosis.…”

An immunohistochemical and clinicopathological study of granulocytic sarcoma (‘chloroma’)

“…Irradiation has been shown to be effective in the temporary management of local problems with chloroma (Muss and Maloney, 1973), particularly spinal cord compression due to extradural deposits, but alone has not prevented acute leukaemia supervening. The earliest reports (Wiernick and Serpick, 1970) of the treatment of chloroma by chemotherapy reflected the low efficacy of antileukaemic chemotherapy then available but using HD-Ara C a complete response lasting 12 months was achieved in case 1 before a further recurrence of chloroma, without marrow relapse. A similar but shorter response to HD-Ara C has recently been reported in a patient with extradural chloroma in the sacral canal recurring after irradiation (Barnett et al, 1984).…”

Granulocytic Sarcoma Preceding Acute Myeloid Leukaemia

“…The diagnostic difficulty encountered when the colourless variant of granulocytic sarcoma occurs in the absence of a leukaemia picture in the blood and bone marrow has been emphasized in severel reports (Laszlo & Grode 1967, Wiernik & Serpick 1970, Brugo et al 1977, Seo et al 1977. We know of at least 14 cases of granulocytic sarcomas preceding acute leukaemia ( Table 1).…”

“…As granulocytic sarcoma most commonly is associated with leukaemic blood and mar-row findings the origin of these tumours rarely gives rise to diagnostic problems. Occasionally, however, a tumour can occur without evidence of leukaemia (Lecene 1927, Ragins & Tinsley 1950, Dameshek & Gunz 1964, Lusher 1964, Comings et a1 1965, Laszlo & Grode 1967, Hurwitz et a1 1970, Wiernik & Serpick 1970, Mason et a1 1973, Brugo et a1 1977, Mathiot et a1 1978, Seo et a1 1977, Krause 1979, and if the classical green colour is lacking, the diagnosis can be misinterpreted by clinician and pathologist. In these instances, the most common misdiagnosis is malignant non-Hodgkin's lymphoma of the histiocytic type (reticulum cell sarcoma).…”