Autopsy study of granulocytic sarcoma (chloroma) in patients with myelogenous leukemia, hiroshima-nagasaki 1949-1969

Abstract

Granulocytic sarcoma (chloroma) was present in 23 of 338 myelogenous leukemia patients autopsied in Hiroshima and Nagasaki during 1949-1969. There was no evidence that granulocytic sarcoma was more frequent among those who received heavy atomic-bomb irradiation, although the incidence of myelogenous leukemia was greatly increased in the heavily irradiated group compared with controls. Granulocytic sarcoma was found in 19 of 237 persons with acute myelogenous leukemia, in 3 of 77 with chronic myelogenous leukemia, and 1 of 24 with chronic myelogenous leukemia with blast crisis. It was distinguished from myelogenous leukemia by: significantly higher frequency in children and young adults; clinical manifestations of pain and tumor formation (often with exophthalmos) followed by paralysis and/or urinary incontinence; slightly shorter survival time; and greater intensity of leukemic infiltration in the pituitary. At autopsy, gross tumors occurred most frequently in bone, ovary, lymph nodes, kidney, dura, lung, arm, and breast. The pathogenesis of tumor formation in leukemia is discussed.