Acute Myeloid Sarcoma: An Unusual Cause of Diarrhea

Abstract

A 62-year-old man with a past medical history of hypothyroidism was admitted for diarrhea and abdominal pain for three weeks. Initial workup for diarrhea was negative. His condition deteriorated after hospitalization. He underwent sigmoidoscopy which showed rectosigmoid mucosal ulceration. Pathology showed leukemic cells infiltration of the mucosa. The patient underwent bone marrow biopsy which confirmed the diagnosis of acute myeloid leukemia (AML). He received induction chemotherapy and his symptoms improved.

Non-Mass-Forming Myeloid Sarcoma of the Colon Presenting With Diarrhea

“…MS in the bowel has been associated with symptoms of obstruction, perforation, and bleeding, but diarrhea is a rather rare presentation and has a broad range of other possible causes, including inflammatory and infectious causes. 3 Given the largely unremarkable endoscopic appearance, microscopic colitis was high on the differential. This case also highlights an uncommon phenotypic manifestation of MS with malignant cells infiltrating the submucosa and lamina propria without causing a discrete mass or thickening on endoscopy or radiology.…”

“…2,3 When MS occurs in the gastrointestinal tract, it has a predilection for involving the small bowel and usually presents with intestinal obstruction related to a mass. 3,4 A spectrum of imaging and endoscopic findings has been described including exophytic luminal masses, polyps, bowel wall thickening, and ulcerated lesions. [4][5][6] This report describes a rare case of non-mass-forming MS in the colon presenting as severe diarrhea in the absence of radiological and significant endoscopic findings.…”

“… 1 It is most frequent in the skin, lymph nodes, or bones; it rarely involves the gastrointestinal tract. 2 , 3 When MS occurs in the gastrointestinal tract, it has a predilection for involving the small bowel and usually presents with intestinal obstruction related to a mass. 3 , 4 A spectrum of imaging and endoscopic findings has been described including exophytic luminal masses, polyps, bowel wall thickening, and ulcerated lesions.…”