Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid cells. It is usually associated with leukemia or other myeloproliferative disorders, but can also occur without overt hematologic disease, i.e. in patients with a normal bone marrow and no history of acute myelogenous leukemia. This primary extramedullary lesion may indeed represent a diagnostic and therapeutic dilemma for both the hematopathologist and oncologist. We describe a case of GS diagnosed in a nonleukemic patient and review the literature regarding the pathologic features and treatment of this condition.

1.
Neiman RS, Barcos M, Berard C, Bonner H, Mann R, Rydell RE, Bennett JM: Granulocytic sarcoma: A clinicopathologic study of 61 biopsied cases. Cancer 1981;48:1426–1437.
2.
Meis JM, Butler JJ, Osborne BM, Manning JT: Granulocytic sarcoma in non-leukemic patients. Cancer 1986;58:2697–2709.
3.
Eshghabadi M, Shojania AM, Carr I: Isolated granulocytic sarcoma: Report of a case and review of the literature. J Clin Oncol 1986;4:912–917.
4.
Tosi A, De Paoli A, Fava S, Luoni M, Sironi M, Tocci A, Assi A, Cassi E: Undifferentiated granulocytic sarcoma: A case with epidural onset preceding acute promyelocytic leukemia. Haematologica 1995;80:44–46.
5.
Whitcomb CC, Sternheim WL, Borowitz MJ, Davila E, Byrne GE Jr: T-cell lymphoma mimicking granulocytic sarcoma. Am J Clin Pathol 1985;84:760–763.
6.
Pileri S: Linfomi maligni non-Hodgkin: dalla tecnica alla diagnostica. Bologna, Società Editrice Esculapio, 1985, pp 8–18.
7.
Pileri SA, Roncador G, Ceccarelli C, Piccioli M, Briskomatis A, Sabattini E, Ascani S, Santini D, Piccaluga PP, Leone O, Damiani S, Ercolessi C, Sandri F, Pieri F, Leoncini L, Falini B: Antigen retrieval techniques in immunohistochemistry: Comparison of different methods. J Pathol 1997;183:116–123.
8.
Cordell JC, Falini B, Erber WN, Ghosh AK, Abdulaziz Z, Mac Donald S, Pulford KA, Stein H, Mason DY: Immunoenzymatic labelling of monoclonal antibodies using immune complexes of alkaline phosphatase and monoclonal anti-alkaline phosphatase (APAAP complexes). J Histochem Cytochem 1984;32:219–229.
9.
Bennett JM, Catovsky D, Daniel MT, Flandrin G, Galton DAG, Gralnick HR, Sultan C: Proposed revised criteria for the classification of acute myeloid leukemia: A report of the French-American-British Cooperative Group. Ann Intern Med 1985;103:620–625.
10.
Pileri SA, Ascani S, Piccioli M, Poggi S, Fraternali Orcioni G, Sabattini E, Milani M, Falini B: Immunophenotyping of acute leukemias in paraffin sections: A powerful tool. Br J Hemathol 1999;105:394–401.
11.
Liu PI, Ishimaru T, Mc Gregor DH: Autopsy study of granulocytic sarcoma (chloroma) in patients with myelogenous leukemia, Hiroshima-Nagasaki 1949–1969. Cancer 1973;31:948–955.
12.
Hudock J, Chatten J, Miettinen M: Immunohistochemical evaluation of myeloid leukemia infiltrates (granulocytic sarcomas) in formaldehyde-fixed, paraffin embedded tissue. Am J Clin Pathol 1994;102:55–60.
13.
Traweek ST, Arber DA, Rappaport H, Brynes RK: Extramedullary myeloid cell tumors: An immunohistochemical and morphologic study of 28 cases. Am Surg Pathol 1993;17:1011–1019.
14.
Byrd JC, Edenfield WJ, Shields DJ, Dawson NA: Extramedullary myeloid cell tumors in acute nonlymphocytic leukemia: A clinical review. J Clin Oncol 1995;13:1800–1816.
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