Journal List > Korean J Gastroenterol > v.68(3) > 1007553

Lim, Lee, Lee, Jun, Kim, Kim, Ahn, and Park: A Case of Myeloid Sarcoma of Intestine

Abstract

Myeloid sarcoma (MS) is an extramedullary involvement of immature myeloid proliferation. An isolated MS is defined as a myeloblastic tumor when it arises without any concomitant circulating disease. A diagnosis of MS is established using pathologic features including infiltration of myeloblasts and strong myeloperoxidase expression with negative cytokeratin immunohistochemical staining. We report a rare case of colonic MS without any peripheral blood abnormality. If the affected patient were left untreated, the MS could evolve into acute myeloid leukemia (AML) within one year. Several studies recommend the same regimens of chemotherapy as used for circulating AML to treat isolated MS. We focused on the diagnosis of MS in this study. The correct diagnosis of MS is important for adequate treatment. In conclusion, MS should be considered in the differential diagnosis of intestinal tumor.

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Fig. 1.
The CT scan reveals an intraluminal annular enhancing mass (arrows) in the terminal ileum to proximal colon area with small bowel dilatation.
kjg-68-148f1.tif
Fig. 2.
A huge, obstructive mass of the ascending colon was found upon colonoscopy. The mass was a fragile exophytic tumor.
kjg-68-148f2.tif
Fig. 3.
Histology revealed myeloid sarcoma involving the colon. (A) Neoblastic cells have dispersed chromatin and inconspicuous nucleoli with an indented nuclear configuration (H&E, ×400). (B) The neoplastic cells are positive for myeloperoxidase (×400).
kjg-68-148f3.tif
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