Myeloid sarcoma without circulating leukemia mimicking gastrointestinal malignancy and lymphoma

We present an unusual case of myeloid sarcoma with ascites and abdominal pain in which initial clinical, laboratory, and imaging studies suggested a gastrointestinal malignancy or lymphoma. Subsequent detection of leukemic ascites and blasts in a gastric, small bowel, and skin biopsy supported a dia...

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Bibliographic Details
Main Authors: Sravanthi Ravulapati, Craig Siegel, Ameesh Dara, Jack M. Lionberger
Format: Article
Language:English
Published: MDPI AG 2018-06-01
Series:Hematology Reports
Subjects:
Online Access:https://www.pagepress.org/journals/index.php/hr/article/view/7040
Description
Summary:We present an unusual case of myeloid sarcoma with ascites and abdominal pain in which initial clinical, laboratory, and imaging studies suggested a gastrointestinal malignancy or lymphoma. Subsequent detection of leukemic ascites and blasts in a gastric, small bowel, and skin biopsy supported a diagnosis of myeloid sarcoma. Bone marrow biopsy revealed 15% blasts, and cytogenetics with an inversion 16 rearrangement was diagnostic of acute myeloid leukemia (AML). Positron emission tomography-computed tomography performed at presentation to stage a presumptive lymphoma found later utility in following the burden of extramedullary disease. Standard AML induction chemotherapy resulted in complete remission and was followed by three rounds of high dose cytarabine consolidation. The patient unfortunately relapsed leading to re-induction followed by allogeneic stem cell transplantation. This report describes the presentation, assessment, and management of myeloid sarcoma.
ISSN:2038-8322
2038-8330