A case of granulocytic sarcoma involving the uterine cerivx as the primary manifestation, before the peripheral blood and bone marrow showed evidences of overt leukemia, is presented. Six weeks after the onset of the genital tract symptom the patient developed acute myelogenous leukemia. The uterine tumor was initially believed to be a histiocytic lymphoma. The diagnosis of granulocytic sarcoma was confirmed by the naphthol AS-D chloracetate stain for esterase, which was performed on the uterine cervix and obturator lymphnodes taken by hysterectomy and pelvic node dissection. The literatrue was reviewed with emphasis on the differential diagnosis of granulocytic sarcoma and histiocytic lymphoma, and the clinical and pathological problems that arise when the tumor presents at an unusual location and without peripheral blood manifestation of leukemia.
Adult ; Cervix Neoplasms/diagnosis* ; Diagnosis, Differential ; Female ; Human ; Leukemia, Myelocytic, Acute/diagnosis* ; Leukemia, Myelocytic, Acute/pathology ; Leukemia, Myeloid/diagnosis* ; Lymphoma/diagnosis

Muscle involvement in acute febrile neutrophilic dermatosis is uncommon. Herein, we report a case of acute febrile neutrophilic myositis, without cutaneous involvement, as the first manifestation of acute myeloid leukemia. The patient was a 35-year-old male, referred due to painful swelling of the left upper arm and fever. The overlying skin looked normal, and a muscle biopsy revealed dense infiltrates, predominantly composed of mature neutrophils, edema and tissue necrosis. All culture reports were negative, and he was finally diagnosed as having acute febrile neutrophilic myositis, associated with acute myeloid leukemia. Corticosteroid treatment resulted in the progressive regression of the fever, myalgia and swelling.
Neutrophils/*metabolism ; Myositis/*etiology/metabolism ; Male ; Leukemia, Myelocytic, Acute/*diagnosis ; Humans ; Fever/etiology ; Adult

Reported here is a case of microsporidiasis that occurred in an acute myeloblastic leukemia (AML) -M3 patient who underwent chemotherapy. Fever, cough, expectorate and dyspnea were observed during the therapy. Since this case was considered as adult respiratory distress syndrome due to the chest X-ray and arterial blood gas findings, the male patient was bounded to a mechanical ventilator. As coagulation tests showed compatible findings with disseminate intravascular coagulation (DIC), it was thought to be a case of sepsis originating from the lungs and DIC. Pseudomonas aeruginosa and Staphylococcus aureus were found in the sputum of the patient. Although he was given combined antibiotic therapy, there was no reduction in the fever. A bronchoalveolar lavage (BAL) sample was taken and Microsporidia sp. was found upon staining with Giemsa. The patient died due to sepsis and DIC just before receiving therapy for microsporidiasis. Pulmonary infection with Microsporidia, although classically occurring in patients with HIV infection, may occur rarely in leukemia patients, especially if previously treated with systemic immune suppression. This case reinforces the need to consider Microsporidia as a possible pathogen in immunocompromised patients with pulmonary infections.
Diagnostic Errors ; Fatal Outcome ; Human ; Immunocompromised Host ; Leukemia, Myelocytic, Acute/*complications ; Lung Diseases, Parasitic/*complications/diagnosis ; Male ; Microsporidiosis/*complications/diagnosis ; Middle Aged

We report a case of granulocytic sarcoma presented as a recurrent breast tumor in a 42-year-old woman with no history of leukemia. The case was initially diagnosed as malignant lymphoma on a previous biopsy specimen and she refused chemotherapy. At the time of recurrence of the breast tumor, the patient showed full-blown features of leukemia. This case of rare tumor suggests that differential diagnosis should be considered when malignant lymphoma of the breast is detected.
Adult ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Breast Neoplasms/diagnosis+ACo- ; Carcinoma, Lobular/diagnosis ; Case Report ; Cell Nucleus/ultrastructure ; Diagnosis, Differential ; Diagnostic Errors+ACo- ; Female ; Human ; Leukemia, Myelocytic, Acute/pathology ; Leukemia, Myelocytic, Acute/diagnosis+ACo- ; Lymphoma, Large-Cell, Diffuse/diagnosis+ACo- ; Neoplasm Recurrence, Local/pathology

We report a case of granulocytic sarcoma presented as a recurrent breast tumor in a 42-year-old woman with no history of leukemia. The case was initially diagnosed as malignant lymphoma on a previous biopsy specimen and she refused chemotherapy. At the time of recurrence of the breast tumor, the patient showed full-blown features of leukemia. This case of rare tumor suggests that differential diagnosis should be considered when malignant lymphoma of the breast is detected.
Adult ; Breast Neoplasms/surgery ; Breast Neoplasms/pathology ; Breast Neoplasms/diagnosis+ACo- ; Carcinoma, Lobular/diagnosis ; Case Report ; Cell Nucleus/ultrastructure ; Diagnosis, Differential ; Diagnostic Errors+ACo- ; Female ; Human ; Leukemia, Myelocytic, Acute/pathology ; Leukemia, Myelocytic, Acute/diagnosis+ACo- ; Lymphoma, Large-Cell, Diffuse/diagnosis+ACo- ; Neoplasm Recurrence, Local/pathology

We report five cases of cytomegalovirus infection in immunocompromised patients which were detected by either cytomegalovirus antigenemia assay or in situ hybridization. Four cases had leukemia and the other had chronic renal failure. All the three BMT recipients suffered from GvHD. Interestingly, there was an unique case of CMV disease without a history of BMT, which reminded us that CMV could attack immunocompromised patients who had not undergone transplantation, too. Four out of five cases died. We think that cytomegalovirus infection or disease should not be regarded as a minor problem in post-transplantation infection in Korea.
Adolescent ; Adult ; Antigens, Viral/*blood ; *Bone Marrow Transplantation ; Case Report ; Cytomegalovirus/*immunology ; Cytomegalovirus Infections/complications/*diagnosis ; Fatal Outcome ; Graft vs Host Disease/complications ; Human ; Immunocompromised Host ; In Situ Hybridization ; Kidney Failure, Chronic/complications ; Kidney Transplantation ; Leukemia/*complications/therapy ; Leukemia, Lymphocytic, Acute, L2/complications/therapy ; Leukemia, Myelocytic, Acute/complications/therapy ; Leukemia, Myeloid, Chronic/complications/therapy ; Male ; Viremia/*diagnosis

Granulocytic sarcoma is a rare extramedullary tumor composed of myeloid progenitor cells. Primary involvement of the biliary tract without evidence of leukemia is exceedingly rare. Here, we report an isolated biliary granulocytic sarcoma in a 30-yr-old man who presented with jaundice, fever, and chill without any evidence of leukemia. However, five months after the diagnosis, he developed acute myelogenous leukemia with multilineage dysplasia and chromosomal abnormality. A rare possibility of biliary granulocytic sarcoma should be considered as a differential diagnosis in patients with obstructive jaundice. A histologic evaluation by aggressive diagnostic intervention is important and may improve prognosis.
Tomography, X-Ray Computed ; Sarcoma, Granulocytic/*complications/*pathology ; Prognosis ; Male ; Leukemia, Myelocytic, Acute/*diagnosis/*pathology ; Karyotyping ; Humans ; Cell Lineage ; Bile Ducts/metabolism/pathology ; Bile Duct Neoplasms/*complications/*pathology ; Adult