Granulocytic Sarcoma Presenting as Subconjunctival Mass

  Chloroma or granulocytic sarcoma (GS) is a malignant neoplasm of myeloid lineage that occur in a variety of anatomic sites other than the bone marrow including soft tissue, bone, lymph node, nasal fossa, skin and sometime in the orbit. In the subconjunctiva it is rarely reported. A 4-year-old girl with a history of treated acute myelogenous leukemia was referred to Farabi Eye Hospital, Tehran, Iran for the evaluation of subconjunctival mass that was appeared since one month ago. Cell blood count (CBC) of the patient was normal except for Hb=7gm/dl. General physical examination was normal except for the signs of anemia. Histopathological evaluation of subconjunctival mass showed a malignant large round cell neoplasm. Immunohistochemical studies confirmed granulocytic sarcoma. When confronting a large cell or undifferentiated round cell neoplasm, the possibility of myeloid sarcoma should be investigated. Myeloperoxidase (MPO), cluster designation (CD) molecules such as CD34, CD45, CD15, CD68 and lysozyme positivity or Leder staining are useful in this regard.