Elsevier

Leukemia Research

Volume 25, Issue 11, November 2001, Pages 1019-1021
Leukemia Research

Case report
Cerebellar granulocytic sarcoma in an infant with CD56+ acute monoblastic leukemia

https://doi.org/10.1016/S0145-2126(01)00068-6Get rights and content

Abstract

Granulocytic sarcoma (GS) is a form of extramedullary leukaemia (EML). The presence of the neural cell adhesion molecule (NCAM) on the surface of the blasts, which is recognized by the CD56 monoclonal antibody, enhances their propensity for tissue penetration. GS within the central nervous system (CNS), in particular within the cerebellum, is extremely uncommon. We review the literature and describe an infant with isolated cerebellar GS relapse, which antedated a CD56+ acute monoblastic leukaemia bone marrow (BM) relapse.

Section snippets

Case report

An 11 month boy was diagnosed with AML M5 without CNS disease, leucocytosis or organomegaly. A difficult BM aspiration yielded a poor sample, infiltrated by monoblasts, inadequate for cytogenetic analysis or immunophenotyping. A BM trephine biopsy showed 90% infiltration by monoblasts, grade 2–3 fibrosis and focal haemophagocytosis. Immunohistochemistry of the BM trephine biopsy sections showed CD15+, CD45R/LCA+, CD68 / PGM1+, CD68/KP-1+, lysozyme+, CD34−, CD61−, CD56−, glycophorin c- and focal

Discussion

Extramedullary leukaemia (EML) represents leukemia cells outside the bone marrow and includes granulocytic sarcomas (GS) at any anatomical site, leukaemia cutis (LC) and meningeal leukaemia (ML) [1]. It can be a presenting feature of evolving AML or an antedating/concomitant feature of medullary relapse [1]. The incidence in adult AML was reported to be between 2.9 and 8% during the non-intensive chemotherapy era [1]. Pui et al. found a 4.7% incidence in children with AML. [3]. Suggested

Acknowledgements

The authors would like to thank Dr. I.M. Hann, Consultant Haematologist, Great Ormond Street Hospital London, and Dr. B.J. Bain for their invaluable comments during the preparation of the manuscripts.

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