Myeloid sarcoma of the stomach - 23/08/11
Doi : 10.1016/j.gie.2008.05.065
| Commentary Myeloid sarcoma is an extramedullary tumor of myeloblasts, myeloid precursors, and neutrophils in various combination. It may be the initial presentation of acute myeloid leukemia, present as a leukemic relapse, or signal impending blast crisis in the setting of a myeloproliferative disorder or leukemic transformation in myelodysplastic syndrome; it also has been described after allogeneic bone marrow transplantation. Myeloid sarcoma has been found in almost every anatomic location, most common of which are the skin, bones, and lymph nodes. The GI tract is also a relatively common location, and the usual presentation is abdominal pain from small-bowel obstruction. Other regions of the GI system that have been reported to be involved include the stomach, colon, appendix, mesentery, and biliary tract. In this case, umbilicated nodules were seen that were responsible for the patient’s bleeding. If one looks closely at the gastric umbilications, one sees their surface has a greenish hue; hence the old name chloroma (Gr. chloros, green) for these lesions. The coloration is now known to be caused by the presence of neutrophil-associated myeloperoxidase, which has a covalently bound heme protein that confers the greenish color. This coloration is lost during formalin fixation of the tissue. Indeed, myeloperoxidase staining was positive in the biopsy specimens and helped distinguish the myeloid sarcoma from other similar-appearing malignancies. Lawrence J. Brandt, MD Associate Editor for Focal Points |
© 2008
American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
Vol 68 - N° 6
P. 1193-1194 - dicembre 2008 Ritorno al numero
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