MYELOSARCOMA PRECEDING ACUTE-LEUKEMIA DIAGNOSED BY FINE-NEEDLE LYMPH-NODE ASPIRATION - REPORT OF 2 CASES

Myelosarcoma (granulocytic sarcoma) is a rare tumor seen in patients w ith known hematologic malignancies such as leukemia, myelodysplastic s yndromes and myeloproliferative disorders, as well as in non-leukemic patients. A correct diagnosis in these cases is often difficult, and t hese are more commonly misdiagnosed as large cell lymphoma. We describ e two women, 40 and 89 years of age respectively, in whom a myelosarco ma involving the neck lymph nodes was diagnosed by cytological examina tion of a fine needle aspiration biopsy, one and 10 weeks before the o nset of acute myelogenous leukemia. The fine needle aspiration techniq ue allowed a quick and unexpected diagnosis to be made demonstrating g ranulocytic differentiation and the presence of myelo-monocytic cells within lymphatic tissue. The simplicity of the procedure, coupled with its reliability and rapidity suggest that fine needle aspiration biop sies should be used more widely as a first choice method in the diagno stic evaluation of palpable lymph nodes.