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Correspondencedescribed a 30-year-old man who developed AML type 4 with marrow
eosinophilia associated with inv(16) 1 month following bowel
obstruction due to GS. The second case of GS of the small intestine
preceding AML type 4 with eosinophilia was published by Russell et
al;7 the karyotype of the marrow cells of this 49-year-old male was
50,XY,+6,+9,+14,inv(16),+22.Our patient has several features in common with the latter case
(inv(16) and double trisomies 9 and 22), but for the absence of
eosinophilia and the type of AML which is denitely of the FAB type
2; however, the blasts composing the granulocytic sarcoma had
some monocytic characteristics which were not found in the marrow
at the diagnosis of the AML. Therefore, to the best of our knowledge,
this is the rst report of a case of GS preceding AML type 2 with
inv(16).F Morel1,2 1Faculte de Medecine, Universite de Bretagne
A Herry1,2 Occidentale, Brest, France;
M-J Le Bris2 2Service de Cytogenetique, Cytologie et Biologie
G Le Calvez3 de la Reproduction, CHU Morvan, Brest, France;
V Marion3 3Service dHematologie Biologique, CHU
C Berthou1,4 Morvan, Brest, France;
M De Braekeleer1,2 4Service dHe2459dHematologie et de Cancerologie, CHUMorvan, Brest, Francematologie Clinique, InstitutReferencesFigure 1 R-banded karyotype showing the paracentric inversion of
chromosome 16 and double trisomies 9 and 22.diagnosis, as the bone marrow is not involved.3,4 Our patient had a
diagnosis of lymphoma before recognizing that it was a GS.Cytogenetic analysis of AML patients with chloroma have rarely
been reported in the literature. However, it appears that patients with
t(8;21)-associated AML type 2 are more prone than others to develop
GS. Indeed, 4.5 to 38% of patients with t(8;21)(q22;q22) developed
GS.1,5Several patients with AML type 4 in conjunction with
GS and abnormalities of chromosome 16, mainly inv(16)(p13;q22)
have also been reported.3,68 However, isolated granulocytic sarcoma
of the small intestine preceding AML is rare; only two patients had a
cytogenetic analysis using banding techniques. Le Beau et al81 Tallman MS, Hakimian D, Shaw JM, Lissner GS, Russell EJ, Variakojis D. Granulocytic sarcoma is associated with the 8;21 translocation in acute myeloid leukemia. JClin Oncol 1993; 11: 690697.
2 Eshghabadi M, Shojania AM, Carr I. Isolated granulocytic sarcoma. report of a case and review of the literature. J Clin Oncol
1986; 4: 912917.3 Quitt M, Elmalach...