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Eosinophilic gastroenteritis or eosinophilic chloroma?

A Julia1, J F Nomdedeu

  • 1Servicio de Hematologia, Hospital General Vall Hebron, Barcelona, Spain. anjulia@cs.vhebron.es

Acta Haematologica
|September 4, 2004
PubMed
Summary

Granulocytic sarcoma, a rare leukemia manifestation, can present in the small intestine. This case highlights its potential to mimic eosinophilic gastroenteritis before progressing to acute myelogenous leukemia with eosinophilia.

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Area of Science:

  • Hematology
  • Gastroenterology
  • Oncology

Background:

  • Granulocytic sarcoma (GS) is an extramedullary tumor of myeloid blasts.
  • GS can precede, coincide with, or follow the diagnosis of acute myelogenous leukemia (AML).
  • AML with eosinophilia (M4Eo variant) is characterized by specific chromosomal abnormalities, notably involving chromosome 16.

Observation:

  • A patient presented with symptoms initially diagnosed as eosinophilic gastroenteritis.
  • The patient responded to corticosteroid therapy for 21 months.
  • The condition eventually transformed into acute myelogenous leukemia with eosinophilia (M4Eo variant).

Findings:

  • This case represents a rare instance of granulocytic sarcoma of the small intestine.
  • The initial presentation mimicked a benign eosinophilic gastrointestinal disorder.

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  • The transformation to M4Eo variant AML occurred after a prolonged period of apparent remission.

    • Implications:

    • Highlights the importance of considering rare hematologic malignancies in the differential diagnosis of refractory eosinophilic gastroenteritis.
    • Suggests that prolonged corticosteroid treatment may mask or delay the diagnosis of underlying myeloid leukemia.
    • Emphasizes the need for vigilant monitoring and re-evaluation in patients with persistent or relapsing gastrointestinal symptoms suggestive of eosinophilic infiltration.