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Myeloid sarcoma of the extrahepatic bile ducts presenting as obstructive jaundice: Case report

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González-Vela MC, Val-Bernal JF, Mayorga M, Cagigal ML, Fernández F, Mazorra F. Myeloid sarcoma of the extrahepatic bile ducts presenting as obstructive jaundice. APMIS 2006;114:666–8.

We report a rare case of myeloid sarcoma (MS) of the extrahepatic bile ducts presenting as obstructive jaundice in a patient without leukemia at time of diagnosis. A 75-year-old female presented with a one-month history of abdominal pain and jaundice. Computerized tomography scan of the abdomen showed stenosis of the extrahepatic bile ducts. Endoscopic retrograde cholangiography disclosed an irregular narrowing of the common biliary duct, suggestive of a cholangiocarcinoma, and resection was performed. Histologic examination showed diffuse transmural infiltration of malignant cells. These cells exhibited medium-sized round nuclei with central nucleoli and eosinophilic cytoplasm, and were strongly positive for myeloperoxidase, CD68, lysozyme, CD45, CD117 (c-kit protein) and CD43. Eight months following surgery the patient presented with multiple cutaneous nodules and bone marrow trephine biopsy showed acute myelomonocytic leukemia. A literature search identified two previously reported cases of MS of the extrahepatic biliary duct. MS should be taken into consideration in the differential diagnosis of a patient with obstructive jaundice. Immunohistochemistry is essential for a correct diagnosis.

Keywords: Myeloid sarcoma; acute leukemia; biliary duct; jaundice

Document Type: Research Article


Affiliations: Department of Anatomical Pathology, “Marqués de Valdecilla” University Hospital, Medical Faculty, University of Cantabria, Santander, Spain

Publication date: September 1, 2006


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