title: Granulocytic sarcoma presenting with lymph node infarction at disease onset.
abstract: A completely infarcted lymph node is an unusual event. However, lymph node infarction should alert the pathologist to the considerable likelihood of malignant lymphoma. We report two unusual cases of acute myeloid leukemia presenting with granulocytic sarcoma at disease onset with a lymph node lesion exhibiting extensive lymph node infarction. The infarcted tissue contained numerous eosinophilic cell ghosts. There were some islands of degenerated, pyknotic medium-sized nuclei resembling lymphoblasts present in the necrotic area. By immunohistochemistry, these medium sized cells were CD3-, CD20-, CD34+, CD43+, CD45RO-, CD68-, CD79a- and myeloperoxidase+ in both cases. Differentiation of granulocytic sarcoma from malignant lymphomas is important for adequate therapy. The present cases indicate that granulocytic sarcoma should be added to the list of differential diagnoses for lymph node infarction.
authors.affiliation: Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan. mkojima@gunma-cc.jp
authors.forename: Masaru
authors.initials: M
authors.lastname: Kojima
authors.forename: Shigeo
authors.initials: S
authors.lastname: Nakamura
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamane
authors.forename: Hideaki
authors.initials: H
authors.lastname: Itoh
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Masawa
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D004804:Eosinophils / Q000473:pathology; D006801:Humans; D007238:Infarction / Q000473:pathology*; D007564:Japan; D007951:Leukemia, Myeloid / Q000175:diagnosis* / Q000473:pathology; D008198:Lymph Nodes / Q000098:blood supply* / Q000276:immunology / Q000473:pathology; D008214:Lymphocytes / Q000276:immunology; D008297:Male; D009333:Neck; D023981:Sarcoma, Myeloid / Q000473:pathology*
chemical_list: D015703:Antigens, CD