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Case Reports
. 2020 Jun 5;12(6):e8462.
doi: 10.7759/cureus.8462.

Pancreatic Myeloid Sarcoma

Ammar Al-Obaidi  1 , Nathaniel A Parker  1 , Yasmine Hussein Agha  1 , Hamzah Alqam  2 , Seth Page  1
Affiliations
Case Reports

Pancreatic Myeloid Sarcoma

Ammar Al-Obaidi et al. Cureus. .

Abstract

Myeloid sarcoma is an isolated extramedullary tumor mass consisting of immature myeloid cells. It is characterized by highly variable outcomes and usually disrupts the normal architecture of the normal tissue in which it originates. It may occur de novo or be associated with other hematological malignancies. Clinical presentation of myeloid sarcomas can be highly variable based on the tumor site, size, and extent of tissue involvement. The diagnosis of myeloid sarcoma is challenging and requires a high index of suspicion. Tissue sampling followed by the use of auxiliary studies is essential for diagnosis. Moreover, bone marrow sampling is necessary to exclude morrow involvement. Currently, the recommended therapeutic regimens for myeloid sarcoma are similar to those for acute myeloid leukemia. Much work remains to be accomplished as myeloid sarcomas, if initially missed or misdiagnosed, have poor overall survival rates. Furthermore, prognostic factors for this malignancy remain poorly understood.

Keywords: acute myeloid leukemia; allogenic bone marrow transplant; chemotherapy; extramedullary leukemia; granulocytic sarcoma; myeloid sarcoma; pancreatic sarcoma.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Abdominopelvic imaging demonstrating a new pancreatic mass.
(A) CT scans of the abdomen and pelvis with contrast shows a new ellipsoid area of hypo-enhancement within the pancreatic head near the region of the ampulla that measures 2.2 x 1.5 cm. (B) A separate area of hypo-enhancement seen more laterally and inferiorly measures 1 cm. The pancreatic duct is not distended.
Figure 2
Figure 2. Pathology provided by Whipple resection shows a pancreatic myeloid sarcoma.
H&E staining of pancreatic tissue specimens shows an infiltrate comprised of diffuse sheets of atypical cells with scant cytoplasm, irregular nuclei, and prominent nucleoli. Myeloid blast cells infiltrate between and through benign pancreatic ducts and acini (H&E x40, x100, and x400). No lymph node involvement is present. The lesional cells show immunoreactivity with cytoplasmic CD68 and dimly with CD117 on immunohistochemical staining. Thus, aberrant B-cell and T-cell expressions are observed, which further supports the diagnosis of MS. H&E, hematoxylin and eosin
See this image and copyright information in PMC

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