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• W2979169483 abstract "Purpose: Granulocytic sarcoma is an extramedullary tumor composed of immature cells of the granulocytic series known to occur in patients with myelodysplastic syndrome, chronic myelogenous leukemia, or acute myelogenous leukemia (AML). It can occur in any organ or tissue, but the most common involved areas are the skin, bone/spine, and lymph nodes and infrequently the small intestine. It rarely occurs in the colon and few cases have been reported in the colon in adults. We describe a case where granulocytic sarcoma was endoscopically diagnosed in the colon and terminal ileum in a patient presenting with gastrointestinal bleed. Methods: 82-year-old Caucasian male with past medical history of stroke, GERD, arthritis presented with a chief complaint of weakness, dizziness and fall. Patient denied any melena, or anal bleeding or hematemesis. Medications included aspirin, ibuprofen 2-3 tablets per day and omeprazole. He denied any toxic habits. He was hemodynamically stable and physical exam revealed hepatospenomegaly. Rectal exam revealed guaiac positive brown stool. Laboratory studies showed anemia and thrombocytopenia. Iron studies were within normal limits. Patient was resuscitated and endoscopy was performed. Upper GI endoscopy revealed small polyps in stomach and a hiatal hernia. No erosions or ulcers were seen. On colonoscopy hematin was found in the colon, diverticulosis and a 10 mm polyp was seen 70 cm from the anal verge, which was removed with snare cautery. Terminal Ileum was intubated and hematin and multiple 8-10 mm ulcerations were seen, which were biopsied. Pathology revealed immature cell infiltrate consistent with extramedullary myeloid tumor (granulocytic sarcoma) of the small bowel and colon. Special stains were positive for Myeloperoxidase and CD 43 and negative for CD3, CD 20 and CD138. Results: Treatment was initiated with anthracyline based chemotherapy. The patient tolerated it poorly and deteriorated clinically over the next 3 months when all therapy was stopped secondary to poor performance status and he requested hospice care. Conclusion: This case demonstrates a rare presentation and an unusual way to make this diagnosis. Myeloid sarcoma (aka chloromas, granulocytic sarcomas) may occur as extramedullary masses without evidence of leukemia in blood or marrow, so called non-leukemic myeloid sarcomas or in association with AML. They may occasionally, as in this case be the first manifestation of AML preceding the onset in marrow and blood by weeks, months or years and present as a gastrointestinal bleed." @default.
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• W2979169483 date "2009-10-01" @default.
• W2979169483 modified "2023-10-14" @default.
• W2979169483 title "An Unusual Endoscopic Diagnosis for Gastrointestinal Bleed" @default.
• W2979169483 doi "https://doi.org/10.14309/00000434-200910003-00938" @default.
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