Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2015; 21(7): 2242-2248
Published online Feb 21, 2015. doi: 10.3748/wjg.v21.i7.2242
Gastric myeloid sarcoma without acute myeloblastic leukemia
Xiao-Li Huang, Jin Tao, Jian-Zhong Li, Xiao-Liang Chen, Jian-Ning Chen, Chun-Kui Shao, Bin Wu
Xiao-Li Huang, Jin Tao, Jian-Zhong Li, Xiao-Liang Chen, Bin Wu, Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Jian-Ning Chen, Chun-Kui Shao, Department of Pathology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, Guangdong Province, China
Author contributions: Huang XL and Tao J contributed equally to this work; Huang XL, Tao J, Li JZ, Chen XL and Wu B analyzed the data and diagnosed and treated the patient; Chen JN and Shao CK provided the pathological diagnosis of gastric biopsy; Huang XL and Wu B wrote the paper.
Supported by the National Natural Science Foundation of China, No. 81370511; the Natural Science Foundation of Guangdong Province, No. S2011020002348; and Fundamental Research Funds for the Central Universities, No. 82000-3281901.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Bin Wu, MD, PhD, Professor, Chairman, Department of Gastroenterology, the Third Affiliated Hospital of Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China. binwu001@hotmail.com
Telephone: +86-20-85253095 Fax: +86-20-85253336
Received: July 2, 2014
Peer-review started: July 2, 2014
First decision: July 21, 2014
Revised: August 10, 2014
Accepted: October 15, 2014
Article in press: October 15, 2014
Published online: February 21, 2015
Abstract

Myeloid sarcomas (MS) involve extramedullary blast proliferation from one or more myeloid lineages that replace the original tissue architecture, and these neoplasias are called granulocytic sarcomas, chloromas or extramedullary myeloid tumors. Such tumors develop in lymphoid organs, bones (e.g., skulls and orbits), skin, soft tissue, various mucosae, organs, and the central nervous system. Gastrointestinal (GI) involvement is rare, while the occurrence of myeloid sarcomas in patients without leukemia is even rare. Here, we report a case of a 38-year-old man who presented with epigastric pain and progressive jaundice. An upper GI endoscopy had shown extensive multifocal hyperemic fold thickening and the spread of nodular lesions in the body of the stomach. Biopsies from the gastric lesions indicated myeloid sarcoma of the stomach. However, concurrent peripheral blood and bone marrow examinations showed no evidence of acute myeloid leukemia. For diagnosis, the immunohistochemical markers must be checked when evaluating a suspected myeloid sarcoma case. Accurate MS diagnosis determines the appropriate therapy and prognosis.

Keywords: Myeloid sarcoma, Stomach, Acute myeloblastic leukemia, Abdominal pain, Immunohistochemistry

Core tip: Myeloid sarcomas (MS) are extramedullary tumors of myeloblasts, myeloid precursors, and neutrophils in various combinations. MS may be an initial indication for acute myeloid leukemia (AML), or they present during leukemic relapses. The small intestine is a relatively common location for these tumors, and their usual presentation includes abdominal pain from a small bowel obstruction. Gastric MS are rarely reported. Here, we report a rare case of gastric MS without AML. The diagnosis was verified by biopsies of the gastric tissues and bone marrow and immunohistochemical staining.