Myeloid sarcomas: a histologic, immunohistochemical, and cytogenetic studyReport as inadecuate

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Diagnostic Pathology

, 2:42

First Online: 31 October 2007Received: 24 September 2007Accepted: 31 October 2007


Context. -Myeloid sarcoma MS is a neoplasm of immature granulocytes, monocytes, or both involving any extramedullary site. The correct diagnosis of MS is important for adequate therapy, which is often delayed because of a high misdiagnosis rate.

Objective. -To evaluate the lineage differentiation of neoplastic cells in MS by immunohistochemistry, and to correlate the results with clinicopathologic findings and cytogenetic studies.

Design. -Histologic and immunohistochemical examinations were performed on formalin-fixed paraffin-embedded tissue samples from 13 cases of MS. They were classified according to the World Health Organization criteria. Chromosomal analysis data were available in 11 cases. Clinical, pathological, and cytogenetic findings were analyzed.

Results. -The study included six male and seven female patients with an age range of 25 to 72 years mean, 49.3 years and a male to female ratio of 1:1.2. MS de novo occurred in 4-13 31% of cases examined. The most sensitive immunohistochemical markers were CD43 and lysozyme present in all cases with MS 13-13, 100%. All de novo MS showed a normal karyotype, monoblastic differentiation, and lack of CD34. The most common chromosomal abnormalities in MS associated with a hematopoietic disorder were trisomy 8 and inv16 2-11, 18%.

Conclusion. -An immunohistochemical panel including CD43, lysozyme, myeloperoxidase MPO, CD68 or CD163, CD117, CD3 and CD20 can successfully identify the vast majority of MS variants in formalin-fixed paraffin-embedded tissue sections. The present report expands the spectrum of our knowledge showing that de novo MS has frequent monoblastic differentiation and frequently carries a normal karyotype.

Electronic supplementary materialThe online version of this article doi:10.1186-1746-1596-2-42 contains supplementary material, which is available to authorized users.

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Author: Borislav A Alexiev - Wenle Wang - Yi Ning - Saranya Chumsri - Ivana Gojo - William H Rodgers - Sanford A Stass - Xianfen


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