Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Mar 15, 2016; 8(3): 321-325
Published online Mar 15, 2016. doi: 10.4251/wjgo.v8.i3.321
Myeloid sarcoma presenting as a colon polyp and harbinger of chronic myelogenous leukemia
Robert Rogers, Mark Ettel, Margaret Cho, Alexander Chan, Xiao-Jun Wu, Antonio G Neto
Robert Rogers, Mark Ettel, Margaret Cho, Antonio G Neto, Department of Pathology, New York University School of Medicine, New York, NY 10003, United States
Alexander Chan, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, United States
Xiao-Jun Wu, Department of Pathology, George Washington University School of Medicine, Washington, DC 20037, United States
Author contributions: All authors equally contributed to this paper.
Institutional review board statement: No study protocol involving human subjects was employed in this case, rendering it exempt from the Institutional Review Board at our institution.
Informed consent statement: The subject of the case report provided informed written consent.
Conflict-of-interest statement: All the authors have no conflicts-of-interest to declare.
Open-Access: 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/
Correspondence to: Xiao-Jun Wu, MD, PhD, Department of Pathology, George Washington University School of Medicine, 2120 L Street NW, Suite 200, Washington, DC 20037, United States. xwu@mfa.gwu.edu
Telephone: +1-202-6776600 Fax: +1-202-6776601
Received: October 3, 2015
Peer-review started: October 4, 2015
First decision: November 5, 2015
Revised: December 11, 2015
Accepted: December 19, 2015
Article in press: December 21, 2015
Published online: March 15, 2016
Processing time: 156 Days and 12 Hours
Abstract

Myeloid sarcoma, also known as granulocytic sarcoma or chloroma is an unusual accumulation of malignant myeloid precursor cells in an extramedullary site, which disrupts the normal architecture of the involved tissue. It is known to occur more commonly in patients with acute myelogenous leukemia and less commonly in those with myelodysplastic syndrome and myeloproliferative neoplasm, such as chronic myelogenous leukemia. The most common sites of involvement include bone, skin and lymph nodes. However, rare cases have been reported in the gastrointestinal tract, genitourinary tract, or breast. Most commonly, a neoplastic extramedullary proliferation of myeloid precursors in a patient would have systemic involvement of a myeloid neoplasm, including in the bone marrow and peripheral blood. Infrequently, extramedullary disease may be the only site of involvement. It may also occur as a localized antecedent to more generalized disease or as a site of recurrence. Herein, we present the first case in the English literature of a patient presenting with an isolated site of myeloid sarcoma arising in the form of a colonic polyp which, after subsequent bone marrow biopsy, was found to be a harbinger of chronic myelogenous leukemia.

Keywords: Myeloid sarcoma; Granulocytic sarcoma; Chloroma; Chronic myelogenous leukemia

Core tip: Myeloid sarcoma rarely presents in the gastrointestinal tract. Rarer still, does myeloid sarcoma manifest in the gastrointestinal tract without systemic involvement by a myeloid neoplasm. This case report documents the first instance in the English literature wherein an isolated extramedullary site of myeloid sarcoma adopting the form of a colonic polyp was found to be a harbinger of chronic myelogenous leukemia.