Granulocytic sarcoma of the colon

Area of Science:

• Oncology
• Gastroenterology
• Hematology

Background:

• Granulocytic sarcoma is an extramedullary tumor of immature granulocytic cells.
• It is associated with myelodysplastic syndrome (MDS), chronic myelogenous leukemia (CML), and acute myelogenous leukemia (AML).
• Colonic involvement is rare and lacks prior endoscopic description.

Observation:

• A 73-year-old man with MDS presented with fever, diarrhea, and abdominal pain.
• Colonoscopy revealed focal ulceration, friability, and nodularity, suggesting Crohn's disease.
• Histology confirmed a dense myeloid cell infiltrate, characteristic of granulocytic sarcoma.

Findings:

• Granulocytic sarcoma can manifest in the colon, presenting with symptoms like fever, diarrhea, and abdominal pain.
• Endoscopic findings may be mistaken for inflammatory bowel disease, such as Crohn's disease.
• Histopathological examination is essential for definitive diagnosis.

Implications:

• Colonoscopy and biopsy are indicated in patients with MDS, CML, or AML who present with gastrointestinal symptoms.
• This diagnostic approach aids in identifying colonic granulocytic sarcoma, even when endoscopic features are atypical.
• Early diagnosis of granulocytic sarcoma in the colon can lead to timely and appropriate patient management.