Korean J Pathol.  2012 Dec;46(6):590-594.

Multiple Jejunal Myeloid Sarcomas Presenting with Intestinal Obstruction in a Non-leukemic Patient: A Case Report with Ultrastructural Observations

• Kim NR
• Lee WK
• Lee JI
• Cho HY

Abstract

Myeloid sarcoma is a rare extramedullary myeloid tumor, which is frequently misdiagnosed when no evidence of leukemia is initially observed. Here, we report on a peculiar case of a 49-year-old man afflicted with multiple masses in the jejunum, the superior mesentery, and the serosa of the transverse colon, without leukemic manifestation. The tumor was composed of undifferentiated small round cells containing eosinophilic cytoplasm, which were negative for myeloperoxidase, nonspecific esterase, lysozyme, terminal deoxynucleotidyl transferase, leukocyte common antigen, CD3, CD4, CD15, CD20, CD30, CD43, CD56, CD68/PG-M1, CD79a, human melanoma black-45, c-kit, and CD34 with positivity only for CD68/KP1, CD99, and vimentin. Under electron microscopy, those cells had abundant membrane-bound cytoplasmic granules that measured 200 to 300 nm in diameter, which were consistent with granulocytic azurophilic granules. The tumor was finally diagnosed as a myeloid sarcoma. The presence of non-leukemic myeloid sarcomas showing immunonegativity for conventional myeloid-leukemic markers necessitated a diagnosis by ultrastructural observation.

Keyword

Sarcoma, myeloid; Jejunum; CD68/KP1; CD99; Microscopy, electron

MeSH Terms

Antigens, CD45
Carboxylesterase
Colon, Transverse
Cytoplasm
Cytoplasmic Granules
DNA Nucleotidylexotransferase
Eosinophils
Humans
Intestinal Obstruction
Jejunum
Leukemia
Melanoma
Mesentery
Microscopy, Electron
Muramidase
Peroxidase
Sarcoma, Myeloid
Serous Membrane
Vimentin
Antigens, CD45
Carboxylesterase
DNA Nucleotidylexotransferase
Muramidase
Peroxidase
Vimentin