Dysplastic megakaryocytes and eosinophilic precursors in the diagnosis of myeloid sarcoma on lymph node fine-needle aspiration cytology: a case series.

OBJECTIVE

To analyze the cases diagnosed as myeloid sarcoma on fine-needle aspiration cytology (FNAC) of lymph nodes.

STUDY

DESIGN

Ten cases of lymph node aspirate diagnosed as myeloid sarcoma were analyzed. FNAC was performed as a routine outpatient procedure in all cases. Correlation with peripheral smear, bone marrow examination, flow cytometry and cytogenetics was done wherever possible.

RESULTS

Diagnosis of a hematologic malignancy, before fine-needle aspiration, was available in only 2 cases. All 10 cases showed eosinophilic precursors while five aspirates showed megakaryocytes with dysplastic forms. Of the 10 cases, 3 were diagnosed as acute myeloid leukemia, 3 as chronic myeloid leukemia, 1 case as juvenile myelomonocytic leukemia, 1 case proved to be precursor T acute lymphoblastic leukemia/lymphoma and 2 patients did not show blasts on peripheral blood smear but showed blasts, dysplastic megakaryocytes and eosinophilic precursors in the aspirate.

CONCLUSION

Thorough workup to search for an underlying hematological malignancy should be done whenever dysplastic megakaryocytes and/or eosinophilic precursors are seen in lymph node aspirate.