Myeloid sarcoma: clinico-pathologic, phenotypic and cytogenetic analysis of 92 adult patients

S A Pileri, S Ascani, M C Cox, C Campidelli, F Bacci, M Piccioli, P P Piccaluga, C Agostinelli, S Asioli, D Novero, M Bisceglia, M Ponzoni, A Gentile, P Rinaldi, V Franco, D Vincelli, A Pileri Jr, R Gasbarra, B Falini, P L Zinzani and M Baccarani


Figure 1.

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(a) An example of MS occurring at the testis level. Note the residual seminiferous tubules (arrowed) (H&E, times 200); (b) MS grows with the context of an adenomatous polyp of the intestine: please, note residual dysplastic glands arrowed (anti-MPO antibody, immunohistochemistry: APAAP technique, Gill's hematoxylin counterstaining (APAAP-IHC+GHC); times 250); (c) typical indian-file growth pattern in a skin biopsy (H&E, times 250); (d) infiltration of the lymph node paracortex; a residual follicle is arrowed (H&E, times 100); (e) example of blastic population (H&E, times 400); (f) differentiated MS of the kidney. Note the tendency to segmentation of the neoplastic cells and a residual tubule (arrowed) (H&E, times 400); inset: macroscopic detail of the tumoural growth in the same case showing the typical green color; (g) tumor with features of megakaryocytic differentiation, as shown by the FVIIIRAg staining (APAAP-IHC+GHC; times 250); the inset highlights the MPO-positive component (idem, times 400); (h) MS of the myelo-monocytic type: the growth consists of highly proliferating and variably sized cells, showing a greyish cytoplasm at Giemsa (times 400); (i) monoblastic MS: the neoplastic elements of large size display indented, kidney-shaped nuclei (H&E; times 400); (j) MS of the intestine: staining for MPO. Note the central unstained area (encircled) that corresponds to a focus of plasmacytoid monocyte differentiation; inset: staining for CLA/HECA452 of the above mentioned focus; the surrounding cells (on the left) are negative (APAAP-IHC+GHC; times 100; inset: times 250); (k) in the same case, CD117 results: once again the encircled focus is negative (APAAP-IHC+GHC; times 100); (l) in the same tumor, CD68/PGM1 positivity is limited to the plasmacytoid monocyte nodule (encircled) (APAAP-IHC+GHC; times 100).