Machii R, Muto A, Okano Y, Akizuki M, Katsumata Y
Department of Medicine, Yokohama Citizen's Hospital.
Rinsho Ketsueki. 2000 Aug;41(8):653-7.
A 73-year-old man was admitted because of back pain and paralysis of the lower extremities. Magnetic resonance imaging of the spine at the Th4-6 level, obtained after gadolinium injection, demonstrated abnormal signal intensity within the Th5-6 vertebral bodies and an extradural soft-tissue mass on the right posterior side of the spinal canal, compressing the thecal sac. The patient underwent prompt decompression with laminectomy, but this was unsuccessful. A biopsy sample of the mass revealed the histological features of granulocytic sarcoma, including diffuse infiltration of numerous cells containing cytoplasmic granules and immunohistochemical positivity for myeloperoxidase. Two months later, a subcutaneous soft-tissue mass appeared at the anterior chest wall, and this was confirmed to be granulocytic sarcoma by microscopic examination. Both of these tumors were radiosensitive, but the patient died of septic shock. Granulocytic sarcoma usually occurs in association with leukemia or other myeloproliferative disorders. However, it is rarely found before leukemia becomes evident in the peripheral blood or bone marrow; only eight such instances have been reported previously.
一名73岁男性因背痛和下肢瘫痪入院。注射钆后进行的脊柱磁共振成像显示，胸4 - 6水平的胸5 - 6椎体信号强度异常，椎管右侧后方硬膜外有一软组织肿块，压迫硬膜囊。患者迅速接受了椎板切除术减压，但未成功。肿块的活检样本显示了粒细胞肉瘤的组织学特征，包括大量含有细胞质颗粒的细胞弥漫性浸润以及髓过氧化物酶免疫组化阳性。两个月后，前胸壁出现一个皮下软组织肿块，经显微镜检查证实为粒细胞肉瘤。这两个肿瘤均对放疗敏感，但患者死于感染性休克。粒细胞肉瘤通常与白血病或其他骨髓增殖性疾病相关。然而，在外周血或骨髓中白血病明显之前很少发现，此前仅报告过8例此类病例。
