| Popis: |
Background Granulocytic sarcoma (GS) of the uterine cervix is an unusual manifestation of acute myeloid leukemia (AML). Also known as chloroma, myeloid sarcoma and extramedullary myeloid sarcoma represents a solid tumor composed of immature white blood cells. Localized granulocytic sarcoma of the uterine cervix as a primary manifestation, preceding peripheral blood and bone marrow evidences of acute myeloic leukemia is very rare. Diagnosis of localized GS is difficult and is often confused with other neoplastic conditions. Methods We report a case of GS of the uterine cervix in a 46-years-old woman. Involvement of the cervix was the first manifestation of AML. The patient underwent colposcopy which was suspicious for malignancy. Colposcopically directed biopsy and cervical smear were taken. Results Cervical cytology smear stained with Papanicolaou stain contained numerous clusters of malignant cells that had monotonous appearance, with ovoid nuclei and coarse chromatin pattern. Nucleoli were present, not prominent, placed excentrically. The cytoplasm was scanty. Smear contained some squamous epithelial cells and plenty of erytrocytes. Cervical biopsy demonstrated diffuse infiltration of cervical tissue with uniform undifferentiated blastic tumor cells that were immunohistochemically stained positive for leukocyte common antigen (LCA), CD68, CD43, antimyeloperoxidase (MPO), lysozyme and partly for CD117 but were negative for CD20, CD3, CD4, CD7, CD8, CD45RO, CD 56, CD34, that was consistant with granulocytic sarcoma. Soon after the diagnosis, the disease progressed to AML and despite of aggresive chemotherapy the patient died six months later. Conclusion(s) Granulocytic sarcoma of the cervix in its localized form is a rare entity. Awareness of this entity, supported with immunohistochemical findings, leads to correct diagnosis but the poor prognosis still remains. |
