Occurrence of granulocytic sarcoma after allogenic hematopoietic stem cell transplantation

Abstract

Myeloid sarcoma (MS), chloroma and granulositic sarcoma (GS) are all used to describe tumours which proliferate as a result of blasts in the extramedullary parts of the body [1]. Chloroma took its’name from the colour of the tumour [1,2]. It is usually green [1] Granulositic sarcoma occurs in Myelodysplastic syndrome (MDS), Chronic Myelocyter Leukemia (CML) and in 2-8% of AML patients, at a younger age [3,4]. İt usually seen at 1-81 years of age and the size of GS can be from 2 to 20 cm [1]. Compression symptoms of pain and bleeding were as a result of the mass effect of GS. We determined the localizing of mass by Positron emission tomography with fluoroD-glucose integrated with computed tomography (FDG-PET CT) [1,5]. Mass is of containing immature granulocytic series cells and also pathological examination is very difficult [6]. There are three pathologic groups. Group-1 predominantly contains myeloblasts which are poorly differentiated. Group -2 contains moderately differentiated myeloblasts and promyelosites. Promyelosites are dominant. Group-3 contains an equal value of well matured promyelosites and myelosites [4]. Mitotic activity is very different in GS. Kİ-67/MIB1 score was always high (50%95%) [1,7]. When we take a biopsy from a different part of the tumor mitotic activity can change [4]. Single body macrophage demonstrates faster tumor cell turnover [4], but GS does not always have uniform structure nor uniform chromosomal anomalies [4,7].