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Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Online ISSN 1827-1812
Pellicanò S. 1, Calzone R. 2, Dattola O. L. 1, Mandica D. 2, Terra L. 1
1 Regione Calabria - ASL n. 5, Ospedale «S. Giovanni di Dio», Divisione di «Malattie Infettive», Crotone;
2 Regione Calabria - ASL n. 5, Ospedale «S. Giovanni di Dio», Dietista
Granulocytic sarcoma (GS) is a tumor formed by myeloid precursors in an extramedullary site and most frequently associated with acute myeloblastic leukemia or with other myeloproliferative disorders. It occurs relatively commonly in Africa and has been reported to affect 10-25% of black children presenting with acute myeloblastic leukemia. Bone, skin, lymph nodes and soft tissue are the most common site. Involvement of other organs has been rarely reported including female genital tract, lung, gastrointestinal tract, orbit and testis. Granulocytic sarcoma in non-leukemic patients is often asymptomatic, frequently misdiagnosed or mistaken for malignant lymphoma. Sometimes it is presented as a reactivation of chronic myeloid leukemia after allogenic marrow transplantation. Uncommon modifications of chromosome 5 long arm or translocation 9-11 and p22-q23 in malignant cells could explain the immature eosinophil reaction in this tumor. An extremely rare case of granulocytic sarcoma of pancreas in the absence of demonstrable hematologic disease is described. The patient was a 39-year-old man admitted because of jaundice. Ultrasonography and computed tomography scanning of the abdomen disclosed a hypointense area about 3,52 cm in diameter near the head of the pancreas. On the basis of these findings carcinoma was suspected and the patient was treated with pancreatic-cephalic-duodenectomy but histologic diagnosis was granulocytic sarcoma. The patient had normal bone marrow and peripheral blood for a further six months from the onset of acute myeloblastic leukemia. It is important to include this entity in the differential diagnosis of: gastrointestinal bleeding particularly in a patient previously diagnosed with myeloid leukemia or preleukemia; breast tumors, especially in tumors with diffuse proliferation of small tumor cells; scapular masses during childhood. Granulocytic sarcoma of pancreas is an uncommon site; from this report it would appear that it may precede other manifestations of leukemia.