title: Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic study.
abstract: BACKGROUND
  Myeloid sarcoma (MS) is a neoplasm of immature granulocytes, monocytes, or both involving any extramedullary site. The correct diagnosis of MS is important for adequate therapy, which is often delayed because of a high misdiagnosis rate.
  
  
  OBJECTIVE
  To evaluate the lineage differentiation of neoplastic cells in MS by immunohistochemistry, and to correlate the results with clinicopathologic findings and cytogenetic studies.
  
  
  METHODS
  Histologic and immunohistochemical examinations were performed on formalin-fixed paraffin-embedded tissue samples from 13 cases of MS. They were classified according to the World Health Organization criteria. Chromosomal analysis data were available in 11 cases. Clinical, pathological, and cytogenetic findings were analyzed.
  
  
  RESULTS
  The study included six male and seven female patients with an age range of 25 to 72 years (mean, 49.3 years) and a male to female ratio of 1:1.2. MS de novo occurred in 4/13 (31%) of cases examined. The most sensitive immunohistochemical markers were CD43 and lysozyme present in all cases with MS (13/13, 100%). All de novo MS showed a normal karyotype, monoblastic differentiation, and lack of CD34. The most common chromosomal abnormalities in MS associated with a hematopoietic disorder were trisomy 8 and inv(16) (2/11, 18%).
  
  
  CONCLUSIONS
  An immunohistochemical panel including CD43, lysozyme, myeloperoxidase (MPO), CD68 (or CD163), CD117, CD3 and CD20 can successfully identify the vast majority of MS variants in formalin-fixed paraffin-embedded tissue sections. The present report expands the spectrum of our knowledge showing that de novo MS has frequent monoblastic differentiation and frequently carries a normal karyotype.
authors.affiliation: Department of Pathology, University of Maryland Medical Center, 22 S Greene Street, Baltimore, MD 21201, USA. balexiev@umm.edu
authors.forename: Borislav A
authors.initials: BA
authors.lastname: Alexiev
authors.forename: Wenle
authors.initials: W
authors.lastname: Wang
authors.forename: Yi
authors.initials: Y
authors.lastname: Ning
authors.forename: Saranya
authors.initials: S
authors.lastname: Chumsri
authors.forename: Ivana
authors.initials: I
authors.lastname: Gojo
authors.forename: William H
authors.initials: WH
authors.lastname: Rodgers
authors.forename: Sanford A
authors.initials: SA
authors.lastname: Stass
authors.forename: Xianfeng F
authors.initials: XF
authors.lastname: Zhao