Miletic H, Scheid C, Stenzel W, Lee J Y, Deckert M
Brain Pathol. 2006 Jan;16(1):91-3. doi: 10.1111/j.1750-3639.2006.tb00568.x.
A 43-year-old woman with a past medical history of breast cancer and an acute myeloid leukemia (AML) presented with headache over a 3-week period. The clinical examination was completely unremarkable. CT and MRI scans showed a contrast enhancing lesion in the left temporal lobe. Histopathologic examination revealed a malignant, hematopoietic tumor with high mitotic activity, areas of necrosis and diffuse infiltration of the brain parenchyma. Positive staining for Chloroacetateesterase and lysozyme of tumor cells identified its myeloid lineage. The diagnosis was granulocytic sarcoma (GS)/chloroma, a metastatic manifestation of AML. Granulocytic sarcoma (GS) most often occurs in patients with AML, myelodysplastic syndromes and myeloproliferative disorders, and can involve any organ. However intracerebral manifestation of GS is a rare event. In this case histopathological features and differential diagnoses of intracerebral GS are discussed.
一名43岁女性,既往有乳腺癌和急性髓系白血病(AML)病史,在3周内出现头痛。临床检查完全无异常。CT和MRI扫描显示左侧颞叶有一个强化病灶。组织病理学检查显示为恶性造血肿瘤,有高有丝分裂活性、坏死区域及脑实质弥漫性浸润。肿瘤细胞氯乙酸酯酶和溶菌酶染色阳性确定其为髓系来源。诊断为粒细胞肉瘤(GS)/绿色瘤,是AML的一种转移表现。粒细胞肉瘤(GS)最常发生于AML、骨髓增生异常综合征和骨髓增殖性疾病患者,可累及任何器官。然而,GS的脑内表现是罕见事件。本文讨论了该病例脑内GS的组织病理学特征及鉴别诊断。