Gastric myeloid sarcoma without acute myeloblastic leukemia

Area of Science:

• Hematology
• Gastroenterology
• Oncology

Background:

• Myeloid sarcoma (MS) is characterized by extramedullary proliferation of myeloid blasts, often presenting as granulocytic sarcoma, chloroma, or extramedullary myeloid tumor.
• While MS can occur in various tissues, gastrointestinal involvement is uncommon, and its presentation in patients without overt leukemia is exceptionally rare.

Observation:

• A 38-year-old male presented with epigastric pain and jaundice, indicative of potential gastrointestinal pathology.
• Upper GI endoscopy revealed extensive multifocal hyperemic fold thickening and nodular lesions in the gastric body.
• Biopsies confirmed the presence of myeloid sarcoma within the gastric lesions.

Findings:

• The patient's peripheral blood and bone marrow examinations did not show evidence of acute myeloid leukemia at the time of diagnosis.
• Immunohistochemical markers are essential for confirming the diagnosis of myeloid sarcoma, distinguishing it from other neoplasms.

Implications:

• This case highlights the importance of considering myeloid sarcoma in the differential diagnosis of gastric lesions, even in the absence of leukemia.
• Accurate and timely diagnosis of myeloid sarcoma is critical for determining appropriate therapeutic strategies and predicting patient prognosis.