GRANULOCYTIC SARCOMA PRESENTING AS A DIFFUSE RENAL MASS BEFORE HEMATOLOGICAL MANIFESTATIONS OF ACUTE MYELOGENOUS LEUKEMIA

Granulocytic sarcoma is a rare tumor composed of granulocytic precurso r cells. The most common sites of involvement include the bones, soft tissue, lymph nodes and skin. Granulocytic sarcoma usually develops as a delayed manifestation of the disease process in patients with known acute myelogenous leukemia. To our knowledge we report the first case of renal granulocytic sarcoma presenting as the first sign of acute m yelogenous leukemia. Computerized tomography and magnetic resonance im aging revealed diffuse nonspecific global tumor infiltration of the ki dney and ureter. Renal granulocytic sarcoma was diagnosed on open rena l biopsy and acute myelogenous leukemia on bone marrow biopsy. There h as been partial response to combination chemotherapy. Renal granulocyt ic sarcoma may diffusely involve the kidney as the only manifestation of acute myelogenous leukemia and it should be included in the differe ntial diagnosis of the many disease entities with global renal involve ment since initial treatment is combination chemotherapy.