GRANULOCYTIC SARCOMA AND MEDIASTINAL MASS

Background. Granulocytic sarcoma is more frequent in adults; it can be a tumoral localization of acute non-lymphoblastic leukemia. This repo rt describes an infantile case revealing an acute myeloid leukemia. Ca se report. A 14 month-old girl was admitted because of enlarged bilate ral cervical lymph nodes. They had increased in volume over the past m onth and were accompanied by fever and anorexia. The liver and spleen were moderately enlarged. Hematologic data were: Hb = 7.5 g%; leucocyt es = 14 900/mm3; platelets = 614 000/mm3. There were no abnormal cells . X-rays and MRI showed a mediastinal mass. Bone scintigraphy was norm al but the myelogram showed a few atypical cells that were also seen i n a biopsy of the cervical lymph node. Electron microscopic examinatio n of these cells showed that they were myeloid in origin. This was con firmed by immunohistochemistry. The cytogenetic examination showed man y chromosomal abnormalities in the lymph node and myelogram. The child is now recovered after nine months of chemotherapy. Conclusion. Diagn osis of acute myeloblastic leukemia in children is difficult when it i s revealed by granulocytic sarcoma without major infiltration of bone marrow. The clinical presentation as a mediastinal mass is rare. The c ytogenetic study was determinant for diagnosis.