De Novo Splenic Myeloid Sarcoma Masquerading as Mesenteric Artery Occlusion Associated Acute Abdomen

Abstract

We present a case of a 41-year-old male who was admitted to an outside hospital for abdominal pain with increasing severity and reported past medical history of seizures and pancreatitis. Abdominal CT imaging revealed acute mesenteric ischemia and a splenic infarction. Concurrently, the patient’s white blood cell count showed minimal leukocytosis with relative monocytosis. Patient underwent a laparotomy that resulted in a mesenteric embolectomy and splenectomy. Reviewing the histological sections of the spleen, accessory spleen and mesenteric emboli clot sections along with additional studies performed at our institution confirmed the diagnosis of an isolated de-novo myeloid sarcoma with monocytic differentiation. Staging of the disease included trephine bone marrow biopsy and ancillary testing on the bone marrow aspirate (i.e. cytogenetics and FISH studies). These studies were negative for bone marrow involvement by acute myeloid leukemia. Follow up positron emission tomography/computed tomography highlighted no new sites of involvement. To the best of our knowledge, this is the second reported case in the literature of an isolated splenic myeloid sarcoma without bone marrow involvement and no history of receiving any treatment. This is the first reported case in the medical literature of this disease entity clinically presenting as mesenteric artery occlusion.

Keywords

Spleen, Myeloid Sarcoma

How to Cite

Gralewski, J. H. & Smith, G. D. & Jethava, Y. & Veeraputhiran, M. K. & Alapat, D., (2018) “De Novo Splenic Myeloid Sarcoma Masquerading as Mesenteric Artery Occlusion Associated Acute Abdomen”, Hematopathology 2(2), p.96-102.

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Authors

Jonathon H. Gralewski (University of Arkansas for Medical Sciences, Little Rock)
George D. Smith (University of Arkansas for Medical Sciences, Little Rock)
Yogesh Jethava (University of Arkansas for Medical Sciences, Little Rock)
Muthu K. Veeraputhiran (University of Arkansas for Medical Sciences, Little Rock)
Daisy Alapat (University of Arkansas for Medical Sciences, Little Rock)

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Creative Commons Attribution-NonCommercial 4.0

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This article has been peer reviewed.

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