Multiple Jejunal Myeloid Sarcomas Presenting with Intestinal Obstruction in a Non-leukemic Patient: A Case Report with Ultrastructural Observations
김나래, 이운기, 이종인, 조현이,
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김나래 ( Kim Na-Rae )
Gachon University Gil Medical Center Department of Pathology
이운기 ( Lee Woon-Kee )
Gachon University Gil Medical Center Department of General Surgery
이종인 ( Lee Jong-In )
Yonsei University Wonju Christian Hospital Department of Internal Medicine
조현이 ( Cho Hyun-Yee )
Gachon University Gil Medical Center Department of Pathology
KMID : 0357920120460060590
Abstract
Myeloid sarcoma is a rare extramedullary myeloid tumor, which is frequently misdiagnosed when no evidence of leukemia is initially observed. Here, we report on a peculiar case of a 49-year-old man afflicted with multiple masses in the jejunum, the superior mesentery, and the serosa of the transverse colon, without leukemic manifestation. The tumor was composed of undifferentiated small round cells containing eosinophilic cytoplasm, which were negative for myeloperoxidase, nonspecific esterase, lysozyme, terminal deoxynucleotidyl transferase, leukocyte common antigen, CD3, CD4, CD15, CD20, CD30, CD43, CD56, CD68/PG-M1, CD79a, human melanoma black-45, c-kit, and CD34 with positivity only for CD68/KP1, CD99, and vimentin. Under electron microscopy, those cells had abundant membrane-bound cytoplasmic granules that measured 200 to 300 nm in diameter, which were consistent with granulocytic azurophilic granules. The tumor was finally diagnosed as a myeloid sarcoma. The presence of non-leukemic myeloid sarcomas showing immunonegativity for conventional myeloid-leukemic markers necessitated a diagnosis by ultrastructural observation.
키워드
Sarcoma; myeloid; Jejunum; CD68/KP1; CD99; Microscopy; electro
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