Glaser C, Michelon B, Peltier J Y, Duboucher C, Bernheim A, Périé G
Service d'Anatomie et de Cytologie Pathologiques, Institut Gustave Roussy, Villejuif.
Ann Pathol. 1998 Jul;18(3):187-91.
A case of pre-leukemic granulocytic sarcoma (GS) of the uterus was found in a 73-year old woman. The diagnosis was suggested by vaginal cytology and the green color of the gross lesions, then confirmed by naphthol AS-D chloro acetate esterase stain and immunohistochemistry on fixed tissue with the anti-lysozyme, anti-myeloperoxidase, CD 43 and CD15 antibodies. At the time of GS discovery, the patient presented no evident leukemia but myelogram contained 20% of blast cells. She developed acute myeloid leukemia 2 months later. Cytogenetic study of the bone marrow revealed chromosome 21 trisomy. GS is frequently mistaken for malignant lymphoma since it expresses some of the leukocytic antigens (leukocyte common antigen, CD 45 RO (UCHL1), MB2). Therefore, the use of a large panel of antibodies, including anti-myeloperoxidase, anti-lysozyme and CD15, is recommended. Precise diagnosis is essential because all GS must be treated as acute myeloid leukemias.
一名73岁女性被发现患有子宫白血病前期粒细胞肉瘤（GS）。阴道细胞学检查及大体病变的绿色外观提示了该诊断，随后通过萘酚AS-D氯乙酸酯酶染色以及对固定组织用抗溶菌酶、抗髓过氧化物酶、CD43和CD15抗体进行免疫组织化学检查得以确诊。在发现GS时，患者无明显白血病表现，但骨髓检查发现有20%的原始细胞。2个月后她发展为急性髓系白血病。骨髓细胞遗传学研究显示21号染色体三体。GS常被误诊为恶性淋巴瘤，因为它表达一些白细胞抗原（白细胞共同抗原、CD45RO（UCHL1）、MB2）。因此，建议使用一大组抗体，包括抗髓过氧化物酶、抗溶菌酶和CD15。准确诊断至关重要，因为所有GS都必须按急性髓系白血病进行治疗。
