Clinicopathological features of granulocytic sarcoma of the ovary

Objective: To study the clinical and pathological features,diagnosis and differential diagnosis of granulocytic sarcoma of the ovary.Methods: Three cases of granulocytic sarcoma of the ovary were observed by HE and immunohistochemical staining,their clinical features analyzed and relevant literature reviewed.Results: The 3 patients were all women of reproductive age,2 presented with lower abdominal pain and dysmenorrhea respectively and 1 detected by medical examination.There was no evidence of leukemia at the time of diagnosis in the 3 patients and no history of leukemia in 2 but a history of acute monocytic leukemia(AML) in 1.An ovary mass was detected by ultrasound examination in 1 case.Histologically,a diffuse monotonous infiltration of medium-sized or large cells was observed in the ovary,and a single-file pattern was found in 2 cases.The cytoplasm was scanty or moderate,with eosinophilic fine granularity in some cells.The nuclei were round or oval with distinct nucleoli and obvious mitoses.Immunohistochemically,the tumor cells were positive for MPO,CD43 and CD99,but not CD3,CD20,CD79a,TdT,CK7,EMA,CA125 and PLAP.Conclusion: Isolated granulocytic sarcoma of the ovary is a rare tumor,which may be misdiagnosed as lymphoblastic lymphoma,small cell carcinoma,disgerminoma or other small round cell tumors.Recognition of its characteristic morphology and immunomarkers and correct diagnosis are essential for the treatment and prognosis of the disease.