Primary Myeloid Sarcoma of the Colon in a 71 Year Old Male Presenting as a Nodule During Screening Colonoscopy

Jeremy S. Ditelberg MD, Ahmed Bedeir MD, Parag Patel DO, Miraca Life Sciences Research Institute, Newton, MA

Myeloid sarcoma (MS) is a solid tumor composed of myeloblasts occurring outside of the bone marrow. Also known as chloroma, extramedullary myeloid tumor or granulocytic sarcoma, it can occur in patients with acute myeloid leukemia (AML), myelodysplastic syndrome (MDS), or myeloproliferative syndromes (MPS). In the setting of a MDS or MPS, the detection of a MS is evidence that the pre-malignant condition has transformed into an acute leukemia. Rarely, MS is diagnosed without a known pre-existing diagnosis of acute leukemia, MDS or MPS – this is referred to as primary MS. Because acute leukemia develops soon after the diagnosis of primary MS in almost all cases, primary MS is considered an initial manifestation of acute leukemia rather than a localized process. MS has been described in numerous organs and tissues, but most commonly involves the skin, bone and lymph nodes. Its occurrence in the colon is exceptionally rare.

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