Hemato-Oncology Division, Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA.
Department of Internal Medicine, Nassau University Medical Center, East Meadow, New York, USA.
Chin Clin Oncol. 2020 Jun;9(3):37. doi: 10.21037/cco-19-250. Epub 2020 May 20.
Pain in abdomen has wide differentials and narrowing down the clinical possibilities depends on type of pain, location, characterization which is usually assisted by imaging studies. Cholecystitis and cholelithiasis are amongst the common causes of acute abdomen. This study reviews the literature for the clinical characteristics, differential diagnosis, treatment and prognosis of reported cases of gallbladder myeloid sarcoma (GB-MS) who presented with abdominal symptoms. A total of 17 cases of GB-MS were studied. The median age was 52 years with age range of 23 to 84 years. All except 1 patient presented with abdominal symptoms. Based on imaging or pathological studies, 3 cases were initially confused with gallbladder lymphoma or cancer. Only 5 patients were treated with AML like chemotherapy. Treatment given included combinations of surgery, chemotherapy, and radiotherapy. None of the cases underwent HSCT for GB-MS. Seven patients were alive till the time of last F/U, 9 succumbed to death while F/U of 1 patient was not available. Irrespective of treatment protocol followed suggesting the poor prognosis in GB-MS cases. In conclusion, acute abdomen complicating blood malignancies is life threatening and can be devastating if not detected and treated in a timely fashion.
腹痛的鉴别诊断范围很广,通过疼痛类型、位置、特征来缩小临床可能性,通常需要影像学研究的辅助。胆囊炎和胆石症是急性腹痛的常见原因。本研究回顾了以腹部症状为表现的胆囊髓系肉瘤(GB-MS)病例的临床特征、鉴别诊断、治疗和预后的文献。共研究了 17 例 GB-MS 患者。中位年龄为 52 岁,年龄范围为 23 岁至 84 岁。除 1 例患者外,所有患者均有腹部症状。根据影像学或病理学研究,有 3 例最初被误诊为胆囊淋巴瘤或癌症。只有 5 例患者接受了类似 AML 的化疗。治疗包括手术、化疗和放疗的组合。没有患者接受 HSCT 治疗 GB-MS。7 例患者在最后一次随访时仍存活,9 例死亡,1 例患者的随访情况不详。无论采用何种治疗方案,GB-MS 患者的预后均较差。总之,血液恶性肿瘤并发的急性腹痛是危及生命的,如果不能及时发现和治疗,可能会造成毁灭性的后果。