A case of myeloid sarcoma followed by acute myeloid leukemia (AML M0)

Abstract

Myeloid sarcoma is a rare extramedullary disease associated with acute myeloid leukemia (AML). We present the case of a 5-year-old boy with myeloid sarcoma followed by acute myeloid leukemia (AML M0). He was admitted to a local hospital because of recurrent vomiting, abdominal pain, and fever. Abdominal CT disclosed swelling of multiple lymph nodes in the abdomen and ileus. The patient was referred to our hospital for further diagnosis and treatment. Oral antibiotics and intravenous hydration were administered for suspected infectious mesenteric lymphadenitis. After the symptoms subsided, the patient was discharged. However, mesenteric lymphadenopathy remained unchanged and the serum-soluble IL-2R level gradually increased. Blastic cells appeared in the peripheral blood two months after the discharge; thus, we performed bone marrow aspiration and laparoscopic mesenteric lymph node biopsy. Tumor cells were positive for the phenotype of myeloid lineage but negative for MPO, indicating myeloid sarcoma caused by acute myeloid leukemia (AML M0). Myeloid sarcoma in mesenteric lymph nodes followed by AML M0 is very rare, but important in the differential diagnosis of mesenteric lymphadenopathy.