Multiple Granulocytic Sarcomas Fig. 1. (A, B) Widespread well-de- marcated variable-sized greenish firm cutaneous nodules over the face, trunk and extremities. Fig. 2. (A) Dense cellular infiltrate among collagen bundles and in the perifollicular areas within the en- tire dermis (H&E, original magni- fication ×40). (B) Higher magnifi- cation reveals homogenous atypi- cal cells with round to oval shaped hyperchromatic nuclei (H&E, origi- nal magnification ×400). showed a mass in the nasopharynx. Histopathologic findings of this lesion are also consistent with granulocytic sarcoma. At that time, there was no systemic involvement of leukemia. Although she was referred to the Department of Hematology, she refused systemic treatment. In Sep- tember 2010, she visited our clinic due to the multiple skin lesions. On laboratory examination, the white blood cell count was 6·2×109 L-1 with 69% segmented neutrophils, 24% lymphocytes, 7% monocytes, 0% eosinophils and 0% basophils, without evidence of abnormal cells. The red blood cell count, platelet count and hemoglobin level were all within the normal range. Bone marrow biopsy showed a normocellular bone marrow without leukemic cell involvement. Histo- pathological examination of a skin biopsy specimen from the trunk revealed a dense cellular infiltrate among collagen bundles and in the perifollicular areas within the entire dermis (Fig. 2A). The infiltrate consisted of homo- genous atypical cells with round to oval hyperchromatic nuclei (Fig. 2B). Tumor cells are positive for Leder stain and immunoperoxidase (Fig. 3A), but negative for CD3, CD20, CD34, TdT and Pax-5 (Fig. 3B). From pathological and immunohistological findings, we confirmed the diagnosis of granulocytic sarcoma for the skin lesions. The patient was transferred to hematology again for proper management, but she refused the treat- ment for personal reasons. Vol. 23, Suppl. 2, 2011 S271