以粒细胞肉瘤导致的阻塞性黄疸为表现的急性髓系白血病。
Acute myeloid leukemia presenting as obstructive jaundice caused by granulocytic sarcoma.
机构信息
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea.
出版信息
Gut Liver. 2007 Dec;1(2):182-5. doi: 10.5009/gnl.2007.1.2.182. Epub 2007 Dec 31.
We report a rare case of granulocytic sarcoma infiltrating the bile duct in a patient with acute myeloid leukemia. A 23-year-old man presented with jaundice and weight loss. A peripheral blood smear revealed blast cells, and the results of an examination of bone marrow aspirate were consistent with acute myeloid leukemia. The bilirubin level increased gradually after induction chemotherapy with cytarabine. Magnetic resonance cholangiopancreatography (MRCP) revealed dilatation of the intrahepatic bile ducts and smooth tapering off at the level of the common hepatic bile duct. Endoscopic retrograde cholangiopancreatography (ERCP) also revealed diffuse narrowing of the proximal common hepatic bile duct. Obstructive jaundice resolved after endoscopic nasobiliary drainage. Remission induction chemotherapy with cytarabine and idarubicin was administered, and the patient remained complete hematological remission with normal liver function tests.
我们报告了一例罕见的急性髓细胞白血病患者胆管内粒细胞肉瘤浸润病例。一名 23 岁男性因黄疸和体重减轻就诊。外周血涂片发现原始细胞，骨髓抽吸检查结果与急性髓细胞白血病一致。阿糖胞苷诱导化疗后胆红素水平逐渐升高。磁共振胆胰管成像（MRCP）显示肝内胆管扩张，胆总管水平呈平滑渐细。内镜逆行胰胆管造影（ERCP）也显示近端胆总管弥漫性狭窄。鼻胆管引流后梗阻性黄疸消退。给予阿糖胞苷和伊达比星诱导缓解化疗，患者完全血液学缓解，肝功能正常。
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