Korean J Gastroenterol.  2016 Sep;68(3):148-151. 10.4166/kjg.2016.68.3.148.

A Case of Myeloid Sarcoma of Intestine

• Lim SW
• Lee HL
• Lee KN
• Jun DW
• Kim IY
• Kim E
• Ahn H
• Park CK

• KMID: 2358717
• DOI: http://doi.org/10.4166/kjg.2016.68.3.148

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.

Keyword

Sarcoma, myeloid; Colonic neoplasms

MeSH Terms

Colon
Colonic Neoplasms
Diagnosis
Diagnosis, Differential
Drug Therapy
Granulocyte Precursor Cells
Humans
Intestines*
Keratins
Leukemia, Myeloid, Acute
Peroxidase
Sarcoma, Myeloid*
Keratins
Peroxidase

Figure

• 

  Fig. 1. The CT scan reveals an intraluminal annular enhancing mass (arrows) in the terminal ileum to proximal colon area with small bowel dilatation.

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  Fig. 2. A huge, obstructive mass of the ascending colon was found upon colonoscopy. The mass was a fragile exophytic tumor.

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  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).

Reference

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