J Korean Soc Radiol.  2017 Jan;76(1):78-82. 10.3348/jksr.2017.76.1.78.

Imaging Findings of Isolated Myeloid Sarcoma of the Stomach in a Nonleukemic Child: A Case Report and Literature Review

• Kim YK
• Kim JH
• Baek HJ
• Kim JW
• Shin SS
• Heo SH

• KMID: 2365056
• DOI: http://doi.org/10.3348/jksr.2017.76.1.78

Abstract

Myeloid sarcoma is an extramedullary solid neoplasm composed of myeloid precursor cells. This tumor usually occurs simultaneously with or following the onset of acute leukemia. Rarely, it can be the first manifestation of acute myeloid leukemia. The tumor can occur anywhere in the body. However, primary involvement of the stomach without evidence of leukemia is exceedingly rare, and to the best of our knowledge, imaging features of isolated myeloid sarcoma of the stomach have not been reported in children. This case illustrates the imaging appearances of isolated myeloid sarcoma that initially manifested as gastric submucosal wall thickening and discusses the differential diagnosis, in a 15-year-old girl without evidence of hematologic malignancy.

MeSH Terms

Adolescent
Child*
Diagnosis, Differential
Female
Hematologic Neoplasms
Humans
Leukemia
Leukemia, Myeloid, Acute
Multimodal Imaging
Sarcoma, Myeloid*
Stomach*

Figure

• 

  Fig. 1 Multimodal imaging of isolated myeloid sarcoma in a nonleukemic child. A. Oblique axial gray-scale ultrasonogram shows marked and hypoechoic thickening of the stomach wall (arrows) with loss of stratification. B, C. Coronal reformatted, contrast-enhanced CT images demonstrate eccentric, marked and homogeneous wall thickening (asterisks) in the lesser curvature of the gastric body. Mucosa of the thickened gastric wall (thin arrows) and perigastric fat planes (thick arrows) are smooth and preserved, which are suggestive of submucosal disease involvement. There is no regional or distant lymphadenopathy. D. Coronal 18F-FDG PET-CT image shows a diffuse hypermetabolic area (maximal standardized uptake value of 15.2) corresponding to the thickened gastric wall (asterisk). E. Upper GI endoscopy reveals extensive enlarged and hyperemic fold thickening (asterisks) with scattered hemorrhagic spots. GI = gastrointestinal, 18F-FDG PET-CT = 18F-fluorodeoxyglucose PET-CT

• 

  Fig. 2 Histopathologic examination of isolated myeloid sarcoma in a nonleukemic child. A. Photomicrograph (hematoxylin-eosin stain, × 100 magnification) shows diffuse infiltrates of leukemic blasts and some maturing granulocytes (asterisks) in the submucosal tissue and intact overlying mucosa (M) of the stomach. B. Microscopic image (hematoxylin-eosin stain, × 400 magnification) demonstrates blastic, hyperchromatic and pleomorphic cells of the granulocytic series, consistent with granulocytic sarcoma.

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