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Small Intestinal Obstruction with Intussusception due to Acute Myeloid Leukemia: A Case Report

Sangeeta Kini1, Anjali Amarapurkar, Meenaskshi Balasubramanian

  • 1Department of Pathology, BYL Nair Ch. Hospital, Mumbai 400008, India.

Case Reports in Gastrointestinal Medicine
|August 29, 2012
PubMed

Insights

Myeloid sarcoma, a rare gastrointestinal manifestation of acute myeloid leukemia (AML), can present as the sole initial symptom. This case underscores the diagnostic challenges and critical need for prompt identification of this aggressive disease.

Area of Science:

  • Oncology
  • Hematology

Background:

  • Myeloid sarcoma can precede acute myeloid leukemia (AML) and may be its only initial presentation.
  • Gastrointestinal involvement by AML is uncommon, typically affecting the small intestine and presenting with vague abdominal pain or obstruction.

Purpose of the Study:

  • To report a challenging case of primary gastrointestinal myeloid sarcoma.
  • To emphasize the diagnostic difficulties and the importance of prompt management.

Main Methods:

  • Case report of a 25-year-old male with prolonged abdominal pain and vomiting.
  • Diagnostic procedures included esophagogastroduodenoscopy (OGD) with biopsy, ileal resection, histology, immunohistochemistry, and bone marrow examination.

Main Results:

  • Initial OGD revealed gastric infiltration; subsequent ileal resection was performed for acute intestinal obstruction.
  • Histology initially suggested non-Hodgkin's lymphoma, but immunohistochemistry confirmed myeloid sarcoma.
  • Bone marrow investigations confirmed concurrent AML, and the patient ultimately succumbed to the disease.

Conclusions:

  • Primary gastrointestinal manifestation of AML, such as myeloid sarcoma, poses significant diagnostic challenges.
  • Early and accurate diagnosis through immunohistochemistry and bone marrow assessment is crucial for timely intervention and management.

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