A 52-year-old woman diagnosed with AML in January 2010 underwent allogeneic peripheral blood stem cell transplantation in December 2010. Bone marrow biopsy following chemotherapy in November of 2010 showed only minimal residual disease. In September 2011, she presented with a palpable right breast mass. Mammography showed a 4 × 4 cm round to oval high density mass with lobulated margins at 12 o’clock in the right breast (Figure 1). Further evaluation with targeted breast ultrasound demonstrated a heterogeneously echoic oval mass with lobulated and ill-defined margins at 12 o’clock, 5 cm from the nipple that measured 3.4 × 3.9 × 4.0 cm in size (Figure 2), and corresponded to the mammographic abnormality. The differential diagnosis included invasive ductal or lobular carcinoma, recurrent AML, and less likely, a benign lesion such as fibroadenoma or phyllodes tumor. The mass was assessed as BI-RADS 4b, and subsequent ultrasound-guided core biopsy revealed granulocytic sarcoma (Figure 3). An ensuing bone marrow biopsy was negative for recurrent AML.
Citation: Yang L, Park JM, Askeland RW , Fajardo LL (2012) Rare Extramedullary Relapse of Acute Myeloid Leukemia Manifested as Granulocytic Sarcoma of the Breast: Imaging Findings and Pathology Correlation. J Med Diagn Meth 1:103.