Kwan LY, Targan SR, Shih DQ. A case of steroid-dependent myeloid granulocytic sarcoma masquerading as Crohn’s disease. World J Gastroenterol 2011; 17(19): 2446-2449 [PMID: 21633646 DOI: 10.3748/wjg.v17.i19.2446]
Corresponding Author of This Article
David Q Shih, MD, PhD, Cedars-Sinai Inflammatory Bowel and Immunobiology Research Institute, 8700 Beverly Blvd., Suite 4066, Los Angeles, CA 90048, United States. david.shih@cshs.org
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. May 21, 2011; 17(19): 2446-2449 Published online May 21, 2011. doi: 10.3748/wjg.v17.i19.2446
A case of steroid-dependent myeloid granulocytic sarcoma masquerading as Crohn’s disease
Lola Y Kwan, Stephan R Targan, David Q Shih
Lola Y Kwan, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14642, United States
Stephan R Targan, David Q Shih, Inflammatory Bowel Disease Center and Immunobiology Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
David Q Shih, Cedars-Sinai Inflammatory Bowel and Immunobiology Research Institute, 8700 Beverly Blvd., Suite 4066, Los Angeles, CA 90048, United States
Author contributions: Kwan LY, Targan SR and Shih DQ analyzed the clinical data and designed the study; Kwan LY and Shih DQ wrote the paper.
Correspondence to: David Q Shih, MD, PhD, Cedars-Sinai Inflammatory Bowel and Immunobiology Research Institute, 8700 Beverly Blvd., Suite 4066, Los Angeles, CA 90048, United States. david.shih@cshs.org
Telephone: +1-310-4237722 Fax: +1-310-4230224
Received: December 17, 2010 Revised: February 8, 2011 Accepted: February 15, 2011 Published online: May 21, 2011
Abstract
Small bowel tumors and Crohn’s disease are common causes of small bowel obstruction. Early stage neoplasms can easily be mistaken for Crohn’s disease. Therefore, thorough work-ups including imaging studies and endoscopic evaluation with biopsies are critical for accurate diagnosis. Here we report a case of an otherwise healthy female with progressive onset of multiple, recurrent obstructive symptoms secondary to terminal ileal narrowing who was referred for management of steroid-dependent Crohn’s disease. After thorough evaluation, the diagnosis was revised to myeloid granulocytic sarcoma involving the terminal ileum. In this case, a delay in diagnosis can be detrimental for prognosis, as myeloid granulocytic sarcoma is highly predictive of underlying acute myeloid leukemia and needs urgent referral for chemotherapy and/or resection.
