Granulocytic sarcoma presenting as pneumonia in a child with t(8;21) acute myelogenous leukemia: diagnosis by fluorescent in situ hybridization.
Granulocytic sarcoma is a soft tissue collection of leukemic cells. The authors describe a 4-year-old boy with M2 acute myelogenous leukemia (AML) who presented with fever, mild nonproductive cough, and hematemesis. Although he was initially diagnosed with nodular pneumonia, rapid resolution of a pulmonary infiltrate following induction chemotherapy was suggestive of a pulmonary granulocytic sarcoma. Interphase fluorescent in situ hybridization (FISH) of the lung biopsy specimen for the t(8;21)(q22;q22) translocation confirmed the retrospective diagnosis of a well-differentiated pulmonary granulocytic sarcoma. Pulmonary granulocytic sarcomas may be underrecognized in children with AML; this may delay anti-leukemic therapy and may lead to ineffective therapy if misdiagnosed as pneumonia.
Lee
Dean A
DA
Texas Children's Cancer Center and Hematology Service, Houston 77030-2099, USA.
Harris
Charles P
CP
Gresik
Vicky M
VM
Rao
Pulivarthi
P
Lau
Ching C
CC
D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015470:Leukemia, Myeloid, Acute / Q000235:genetics / Q000473:pathology*; D008168:Lung / Q000473:pathology; D008297:Male; D011014:Pneumonia / Q000473:pathology*; D023981:Sarcoma, Myeloid / Q000473:pathology*; D014178:Translocation, Genetic