Youn Seo Yeon, Shin Yu Ri, Park Gyeongsin
Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 14662, Republic of Korea.
Department of Hospital Pathology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 14662, Republic of Korea.
Diagnostics (Basel). 2024 May 21;14(11):1062. doi: 10.3390/diagnostics14111062.
Myeloid sarcoma, a rare extramedullary manifestation of acute myeloid leukemia (AML), can occur in various anatomic sites but seldom involves the gastrointestinal tract. We report the unusual case of a 49-year-old man with a history of AML who initially presented with abdominal pain and imaging findings suggestive of a paracolic abscess. However, the lesion rapidly progressed to a large descending colon mass with peritoneal involvement over five weeks. Surgical resection and histopathological examination confirmed a diagnosis of myeloid sarcoma. This case highlights the potential of myeloid sarcoma to mimic an inflammatory colonic process at initial presentation prior to manifesting as an overt mass lesion. Although exceedingly rare, myeloid sarcoma should be considered in patients with a history of AML presenting with colon lesions, particularly in those with an aggressive clinical course. Early recognition may expedite appropriate treatment and prevent unnecessary procedures. This report also underscores the importance of correlating imaging findings with clinical history and histopathology findings to establish an accurate diagnosis.
髓系肉瘤是急性髓系白血病（AML）一种罕见的髓外表现，可发生于各种解剖部位，但很少累及胃肠道。我们报告了一例不寻常的病例，一名49岁有AML病史的男性，最初表现为腹痛，影像学检查结果提示结肠旁脓肿。然而，在五周内，病变迅速进展为降结肠巨大肿块并累及腹膜。手术切除及组织病理学检查确诊为髓系肉瘤。该病例突出了髓系肉瘤在最初表现为明显肿块病变之前，可能在初始表现时模拟炎性结肠病变的可能性。尽管极为罕见，但对于有AML病史且出现结肠病变的患者，尤其是那些临床病程进展迅速的患者，应考虑髓系肉瘤。早期识别可能会加快适当治疗并避免不必要的手术。本报告还强调了将影像学检查结果与临床病史及组织病理学检查结果相关联以建立准确诊断的重要性。
