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Myeloid Sarcoma : Gross Pathology

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Gross Pathology: Myeloid sarcomas are fleshy tumors that may exhibit characteristic greenish hue (the basis for the term chloroma; chloros = pale green in greek). The green color is notable in tumors with granulocytic differentiation and is due to high levels of the enzyme myeloperoxidase (previously known as verdoperoxide) in cytoplasmic granules of neoplastic cells. The green color fades in 2 to 3 hours upon exposure to air due to oxidation of the enzyme.

About 60-70% of tumors are not green, hence the term chloroma is no longer preferred. The appearance of the tumor may be white, gray, or brown depending upon the concentration levels of myeloperoxidase and its oxidation status in the blasts.

This autopsy specimen from a patient with acute myeloid leukemia shows rather striking green tumor (myeloid sarcoma) involving the kidney.

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