A case of CD56+ cutaneous aleukaemic granulocytic sarcoma with myelodysplastic syndrome

Abstract

We describe a 70-year-old man with cutaneous granulocytic sarcoma who presented with numerous cutaneous nodules but without any leukaemic involvement of the peripheral blood. The tumour cells were positive for lysozyme, peroxidase, CD11a, CD11c, CD33 and HLA-DR, and weakly positive for CD4 and CD14, suggesting granulocytic differentiation. The bone marrow at admission showed dysplasia of the erythrocytic and granulocytic lineage and complex chromosomal abnormalities in association with an increase in monocytes. The patient was diagnosed as having granulocytic sarcoma of monocytic lineage with concomitant myelodysplastic syndrome. In this case, tumour cells also expressed the neural cell adhesion molecule (CD56), which has been suggested as a possible risk factor for developing granulocytic sarcoma in acute myelogenous leukaemia.

Myeloid Sarcoma: Clinical and Morphologic Criteria Useful for Diagnosis

“…CD 30 expression has been reported in a few cases [28]. Some blasts of myeloid sarcoma may express one or more B-cell-associated (i.e., CD 20, CD 79a) or NK/T-cell-associated antigens (i.e., CD 7, CD 2, CD 4).…”

Myeloid sarcoma of the vulva as the initial presentation of acute myeloid leukaemia

“…1 In our patient, tumour cells also expressed CD56, which has previously been implicated as a possible risk factor for development of myeloid sarcoma. [4][5][6] Involvement of the female genital tract by myeloid sarcoma is an uncommon occurrence. Cases of myeloid sarcoma involving the ovary, cervix, uterus and vagina have previously been documented.…”

Cutaneous CD4+ CD56+ hematologic malignancies

“…Of the 32 cases 47% developed AML 38 weeks after the initial diagnosis of the granulocytic sarcoma although the other patients did not develop AML. [25][26][27] We also observed two cases of classic T-cell lymphomas, namely anaplastic large cell lymphoma and MF whereby there was expression of CD56. In the 8 other published cases of CD56 1 variants of cutaneous anaplastic large cell lymphoma 3 were associated with a CD4 phenotype, two with a CD8 phenotype, and 3 demonstrated a null phenotype.…”