Myeloid sarcoma as a differential diagnosis of small bowel obstruction

Bastian Kettler, Mahmoud Abbas, Bastian Ringe, Lothar Hambach, Jürgen Klempnauer, Michael Winkler, Hans-Heinrich Kreipe, Nikos Emmanouilidis

Clinic for General-, Abdominal- and Transplant-Surgery, Medical School Hannover, Hannover, Germany;.
Clinic for Haematology, Medical School Hannover, Hannover, Germany.
Institute for Pathology, Medical School Hannover, Hannover, Germany.

DOI: 10.4236/crcm.2013.22047                

Abstract

We are presenting the case of a 42-year-old  male patient, who was hospitalized due to an acute small bowel obstruction caused by a tissue mass of the mesentery. The patient reported that he had a history of a testicular tumour. For therapy of intestinal obstruction as well as for diagnostic reasons we decided to perform  an explorative laparotomy. On histopathological examination the immunohistological staining was positive for myeloperoxidase (MPO) and KP-1 (CD68). Staining was slightly positive for Bcl-2, CD117, CD34, but negative for CD3, CD4, CD5, CD8, CD20, CD30, CD79, Bcl-6 and S-100. This leads to the diagnosis of a myeloid sarcoma. After recovery from surgery and chemotherapy, allogenic bone marrow transplantation was performed. Most intestinal obstructions are caused by postoperative adhesions or hernias and only in rare cases caused by a myeloid sarcoma.

Keywords

Myeloid Sarcoma; Small Bowel Obstruction

Conflicts of Interest

The authors declare no conflicts of interest.

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