Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2019 Oct 14;14(12):1487-1490.
doi: 10.1016/j.radcr.2019.09.018. eCollection 2019 Dec.

De novo myeloid sarcoma as a rare cause of small bowel obstruction: CT findings and histopathologic correlation

Bülent Aslan  1 , Davut Tüney  1 , Yiğit Erçetin  2 , Süheyla Uyar Bozkurt  2 , Tevfik Kıvılcım Uprak  3
Affiliations
Case Reports

De novo myeloid sarcoma as a rare cause of small bowel obstruction: CT findings and histopathologic correlation

Bülent Aslan et al. Radiol Case Rep. .

Abstract

Small bowel obstruction caused by myeloid sarcoma in a patient with any hematological abnormality is very rare. Myeloid sarcoma occurs most commonly in patients with acute myelogenous leukemia (AML) and less with other hematological disorders. A 57-year-old female presented with abdominal pain, nausea, vomiting, and constipation. Radiological studies showed concentric bowel thickening in distal ileum that caused nearly total luminal compromise and signs of obstruction in proximal ileal bowel loops. She underwent laparotomic surgery and ileal resection was done. Diagnosis of myeloid sarcoma was made by histopathological examination of surgical specimens. Bone marrow biopsy was done to rule out systemic acute myelogenous leukemia (AML). Results of bone marrow biopsy were within normal limits. Finally, the patient was diagnosed as de novo myeloid sarcoma. Although the histopathological examination makes a definitive diagnosis, imaging allows to locate the lesion, evaluate its complications, and guide for correct biopsy. Accurate diagnosis of myeloid sarcoma has important prognostic value as transformation to AML can happen without chemotherapy or stem cell transplantation.

Keywords: Acute leukemia; Chloroma; Granulocytic sarcoma; Isolated myeloid sarcoma; Small bowel obstruction.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Axial and sagittal contrast-enhanced CT scans of abdomen showing concentric focal bowel wall thickening with homogenous enhancement and nearly total luminal compromise (Arrows).
Fig. 2
Fig. 2
Coronal reformatted contrast-enhanced CT image showing concentric bowel wall thickening in distal ileum (thick long arrows) causing luminal narrowing and dilatation of proximal bowel loops (thick short arrows) with clear “feces sign” (thin long arrow).
Fig. 3
Fig. 3
Axial contrast-enhanced CT image showing a minimally enlarged lymph node (arrow) proximal to bowel wall thickening.
Fig. 4
Fig. 4
Resected small bowel gross specimen; a circular mass reaching serosal surface of small bowel.
Fig. 5
Fig. 5
Diffuse infiltration of large pleomorphic cells with blastoid features; high nucleocytoplasmic ratio, narrow eosinophilic cytoplasm (20×, 400×, Hematoxylin-Eosin).
Fig. 6
Fig. 6
Proliferating cells were diffusely positive for myeloperoxidase (MPO) (100×).
See this image and copyright information in PMC

References

    1. Miliauskas J.R., Crowley K.S. Granulocytic sarcoma (chloroma) of the small intestine with associated megakaryocytes. Pathology. 1985;17(559):661–662. - PubMed
    1. Catalano M.F., Levin B., Hart R.S., Troncoso P., DuBrow R.A., Estey E.H. Granulocytic sarcoma of the colon. Gastroenterology. 1991;100:555–559. - PubMed
    1. Corpechot C., Lemann M., Brocheriou I. Granulocytic sarcoma of the jejunum: a rare cause of small bowel obstruction. Am J Gastroenterol. 1998;93:2586–2588. - PubMed
    1. Neiman R.S., Barcos M., Berard C. Granulocytic sarcoma: a clinicopathologic study of 61 biopsied cases. Cancer. 1981;48:1426–1437. - PubMed
    1. Imrie K.R., Kovacs M.J., Selby D. Isolated chloroma: the effect of early antileukemic therapy. Ann Intern Med. 1995;123:351–353. - PubMed

Publication types

LinkOut - more resources