WikiDoc Resources for Granulocytic sarcoma
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- Granulocytic sarcoma (GS, also known as chloroma) was first discovered by Allen Burns, a British physician, in 1811 .
- The term chloroma was first used by King to address the greenish appearance of the tumor due to myeloperoxidase.
- The association of the GS with acute myeloid leukemia was first recognized bt Dock in 1902 .
- The term granulocytic sarcoma was suggested by Rappaport in 1967 to grant generalisability to it .
- GS can be classified into two categories based on its co-occurence with other malignancies:
- GS associated with other myeloid diseases:
- acute leukemias (especially acute myeloid leukemia)
- myelodysplastic syndromes
- other myeloproliferative diseases
- Isolated GS
- Infiltration of the tumor with myeloblasts is the main characteristic of the tumor on H&E stain.
- GS rises from primitive precursors of granulocytes.
- The disease is an extramedullary manifestation of myeloid diseases, however, it can occur as a primary disease.
- Aggregation of myeloblasts, promyelocytes and myelocytes outside of the bone marrow presents itself as these solid tumors.
- Tumors can occur at any site and can appear as green, gray, white or brown masses.
Differentiating [disease name] from other Diseases
- Granulocytic sarcoma must be differentiated from other diseases that can present as extramedullary solid tumors, such as:
- Large cell lymphoma
- Non-Hodgkin lymphoma
- Esosinophilic sarcoma
- Ewing sarcoma
- Extramedullary sites of hematopoiesis
- All patients with granulocytic sarcoma must be evaluated for concurrent or future malignancies as granulocytic sarcoma can occur in the course of or prior to other malignancies.
Epidemiology and Demographics
- The prevalence ofgranulocytic sarcoma is approximately 2 per 1,000,000 individuals worldwide.
- Most of the cases of granulocytic sarcoma are case reports and the disease is extremely rare.
- Patients of all age groups may develop granulocytic sarcoma.
- Granulocytic sarcoma associated with acute myleloid leukemia occurs more commonly in children.
- Granulocytic sarcoma affects both men and women.
- Due to the rarity of the disease it is not clear whether there is a gender predilection for it.
- There is no racial predilection for granulocytic sarcoma.
- Risk factors for granulocytic sarcoma are usually chromosomal aberrations and include:
- Trisomy 8
- Monosomy 7
- MLL gene rearrangement
Natural History, Complications and Prognosis
- The majority of patients with [disease name] remain asymptomatic for [duration/years].
- Early clinical features include [manifestation 1], [manifestation 2], and [manifestation 3].
- If left untreated, [#%] of patients with [disease name] may progress to develop [manifestation 1], [manifestation 2], and [manifestation 3].
- Common complications of [disease name] include [complication 1], [complication 2], and [complication 3].
- Prognosis is generally [excellent/good/poor], and the [1/5/10year mortality/survival rate] of patients with [disease name] is approximately [#%].
- The diagnosis of [disease name] is made when at least [number] of the following [number] diagnostic criteria are met:
- [criterion 1]
- [criterion 2]
- [criterion 3]
- [criterion 4]
- [Disease name] is usually asymptomatic.
- Symptoms of [disease name] may include the following:
- [symptom 1]
- [symptom 2]
- [symptom 3]
- [symptom 4]
- [symptom 5]
- [symptom 6]
- Patients with [disease name] usually appear [general appearance].
- Physical examination may be remarkable for:
- [finding 1]
- [finding 2]
- [finding 3]
- [finding 4]
- [finding 5]
- [finding 6]
- There are no specific laboratory findings associated with [disease name].
- A [positive/negative] [test name] is diagnostic of [disease name].
- An [elevated/reduced] concentration of [serum/blood/urinary/CSF/other] [lab test] is diagnostic of [disease name].
- Other laboratory findings consistent with the diagnosis of [disease name] include [abnormal test 1], [abnormal test 2], and [abnormal test 3].
- There are no [imaging study] findings associated with [disease name].
- [Imaging study 1] is the imaging modality of choice for [disease name].
- On [imaging study 1], [disease name] is characterized by [finding 1], [finding 2], and [finding 3].
- [Imaging study 2] may demonstrate [finding 1], [finding 2], and [finding 3].
Other Diagnostic Studies
- [Disease name] may also be diagnosed using [diagnostic study name].
- Findings on [diagnostic study name] include [finding 1], [finding 2], and [finding 3].
- There is no treatment for [disease name]; the mainstay of therapy is supportive care.
- The mainstay of therapy for [disease name] is [medical therapy 1] and [medical therapy 2].
- [Medical therapy 1] acts by [mechanism of action 1].
- Response to [medical therapy 1] can be monitored with [test/physical finding/imaging] every [frequency/duration].
- Surgery is the mainstay of therapy for [disease name].
- [Surgical procedure] in conjunction with [chemotherapy/radiation] is the most common approach to the treatment of [disease name].
- [Surgical procedure] can only be performed for patients with [disease stage] [disease name].
- There are no primary preventive measures available for [disease name].
- Effective measures for the primary prevention of [disease name] include [measure1], [measure2], and [measure3].
- Once diagnosed and successfully treated, patients with [disease name] are followed-up every [duration]. Follow-up testing includes [test 1], [test 2], and [test 3].
- Burns, Allen. "Observations of surgical anatomy, in Head andNeck". London, England, Royce, 1811: 364–366.
- Dock G, Warthin AS. "A new case of chloroma withleukemia". Trans Assoc Am Phys, 1904. 19:64: 115.
- Rappaport H (1967). Tumors of the hematopoietic system, inAtlas of Tumor Pathology, Section III. Washington: Fascicle 8. ArmedForces Institute of Pathology. pp. 241–247.