Mediastinal Adenopathy in Granulocytic Leukemia

Prominent adenopathy is a common sign of malignant lymphoma, especially Hodgkin disease. It rarely occurs in association with the granulocytic leukemias, 1 but when it does, it is usually as a terminal manifestation. 2-7 The occurrence of prominent mediastinal adenopathy as an initial sign of granulocytic leukemia is distinctly unusual and has not been reported previously. We describe two patients with granulocytic leukemia in whom massive mediastinal adenopathy was the characteristic finding at their initial examination. In one of the two cases, the lymph node tumor preceded blastic leukemia by six months. The clinical and histopathologic features are discussed with reference to the occurrence of extramedullary myeloid tumors associated with acute myelomonocytic leukemia (AML) and chronic granulocytic leukemia (CGL). Patient Summaries Patient 1. —A 44-year-old white woman was in good health until May 1971 when she first noted a supraclavicular mass. At this time, she experienced mild fatigue and malaise