Nonleukemic granulocytic sarcoma in the bile duct: a case report

J Korean Med Sci. 2006 Aug;21(4):745-8. doi: 10.3346/jkms.2006.21.4.745.

Abstract

Granulocytic sarcoma (GS) is an extramedullary tumor composed of immature myeloid cells, typically occurring during the course of acute myelogenous leukemia. Non-leukemic GS, that is, GS with no evidence of overt leukemia and no previous history of leukemia, is very rare, and even more unusual is nonleukemic GS of the bile duct. We report a case of nonleukemic GS of the bile duct. The patient was initially misdiagnosed as a bile duct carcinoma arising in the hilum of the liver (so-called Klatskin tumor), and received a right lobectomy of the liver. Histological examination of the tumor yielded the diagnosis of GS, and the bone marrow biopsy did not show any evidence of leukemia. Considering the risk of subsequent development of overt leukemia, the patient was treated with two cycles of combination chemotherapy as used in the cases of acute myelogenous leukemia. To date, he has remained free of disease 15 months after treatment.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bile Duct Neoplasms / chemically induced*
  • Bile Duct Neoplasms / diagnostic imaging
  • Bile Duct Neoplasms / metabolism
  • Bile Ducts / chemistry
  • Bile Ducts / pathology
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry
  • Leukocyte Common Antigens / analysis
  • Male
  • Peroxidase / analysis
  • Radiography, Abdominal
  • Sarcoma, Myeloid / diagnosis*
  • Sarcoma, Myeloid / diagnostic imaging
  • Sarcoma, Myeloid / metabolism
  • Tomography, X-Ray Computed / methods

Substances

  • Peroxidase
  • Leukocyte Common Antigens