Acute Myeloid Leukemia Presenting as Myeloid Sarcoma with a Predisposition to the Gynecologic Tract

Figure 2

(a) The (right or left) ovary exhibits stromal hyperplasia that replaces the medulla (hematoxylin and eosin). (b) There is a dense proliferation of oval- to spindle-shaped stromal cells in the ovary exhibiting a vaguely nodular pattern (hematoxylin and eosin). (c) There were a few foci of ovarian stromal hyperthecosis consisting of single cells with small clusters of luteinized cells which have abundant, lightly vacuolated cytoplasm (hematoxylin and eosin). (d) A microscopic granulosa cell tumor was seen in the left ovary which showed the microfollicular cell pattern (Call-Exner bodies; hematoxylin and eosin). (e) Cross-section of the fallopian tube showing focal infiltration by atypical, blastic appearing mononuclear cells (arrow; hematoxylin and eosin). (f) The infiltrating blasts had open chromatin and prominent nucleoli. A few with admixed lymphocytes were also present (arrows; hematoxylin and eosin). (g) Endometrial biopsy showing infiltration by the blasts. Note that the blasts have a moderate amount of eosinophilic cytoplasm (hematoxylin and eosin). (h) Immunohistochemical staining showed that the blasts were CD56 positive (immunoperoxidase).

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