title: Granulocytic sarcoma presenting as pneumonia in a child with t(8;21) acute myelogenous leukemia: diagnosis by fluorescent in situ hybridization.
abstract: 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.
authors.affiliation: Texas Children's Cancer Center and Hematology Service, Houston 77030-2099, USA.
authors.forename: Dean A
authors.initials: DA
authors.lastname: Lee
authors.forename: Charles P
authors.initials: CP
authors.lastname: Harris
authors.forename: Vicky M
authors.initials: VM
authors.lastname: Gresik
authors.forename: Pulivarthi
authors.initials: P
authors.lastname: Rao
authors.forename: Ching C
authors.initials: CC
authors.lastname: Lau
mesh_terms: 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