Kilic G, Boruban M C, Bueco-Ramos C, Konoplev S N
Department of Gynecologic Oncology, The University of Texas M. D. Anderson Cancer Center Houston, Texas, USA.
Eur J Gynaecol Oncol. 2007;28(4):270-2.
Granulocytic sarcoma is an extramedullary tumor associated with acute myelogenous leukemia (AML) and it is rarely seen in the female genital tract. We report an unusual case of granulocytic sarcoma of the uterus and fallopian tube in an AML patient who presented with vaginal bleeding and persistent abdominal pain. She was under chemotherapy. Biopsy did not reveal the diagnosis. After laparoscopic examination, hysterectomy with bilateral salpingo-oophorectomy was performed. Pathology showed atypical myeloid cells infiltrating the muscle bundles which was consistent with granulocytic sarcoma involving the uterus and right fallopian tube. Immunohistochemistry confirmed the diagnosis. The patient is in complete remission for AML and being followed-up for granulocytic sarcoma. Granulocytic sarcoma of the uterus and fallopian tube is very rare, and in AML patients with abnormal uterine bleeding but negative endometrial biopsy it should still be considered in the differential diagnosis.
粒细胞肉瘤是一种与急性髓系白血病（AML）相关的髓外肿瘤，在女性生殖道中很少见。我们报告了一例不寻常的AML患者，其子宫和输卵管发生粒细胞肉瘤，表现为阴道出血和持续性腹痛。她正在接受化疗。活检未明确诊断。腹腔镜检查后，进行了子宫切除术及双侧输卵管卵巢切除术。病理显示非典型髓样细胞浸润肌束，符合累及子宫和右侧输卵管的粒细胞肉瘤。免疫组化确诊了诊断。该患者的AML处于完全缓解状态，正在对粒细胞肉瘤进行随访。子宫和输卵管的粒细胞肉瘤非常罕见，对于有异常子宫出血但子宫内膜活检阴性的AML患者，在鉴别诊断中仍应考虑该病。
