TY - JOUR
T1 - Isolated relapse of acute myelogenous leukemia presenting as a gastric ulcer
AU - Roy, Jean
AU - Vercellotti, Gregory
AU - Fenderson, Mary
AU - Mulvahill, Amy
AU - Snover, Dale
AU - Weisdorf, Daniel
PY - 1991/8
Y1 - 1991/8
N2 - Isolated gastrointestinal (GI) infiltrate is unusual at presentation or relapse of acute myelogenous leukemia (AML). We report a case of acute myelogenous leukemia (FAB‐M4) whose isolated relapse presented as a bleeding gastric ulcer. The patient was a 30‐year‐old male who had been diagnosed to have AML in June 1988. While in third complete remission, he underwent a sibling allogeneic HLA‐matched bone marrow transplant. Five months after transplantation, he was readmitted for pneumonia. While in the hospital, he had an episode of upper GI bleeding. The endoscopy revealed a leukemic gastric ulcer, with morphology and immunophenotyping identical to his initial AML. There was no evidence of leukemia in the blood or bone marrow. Although different types of leukemic infiltrates have been recognized at post‐mortem examination, our case is unique because AML presenting as an isolated malignant ulcer has not been described previously. We conclude that relapsing AML may present as an isolated gastric ulcer and suggest that any suspicious lesion on upper GI endoscopy should be biopsied after aggressive platelet support.
AB - Isolated gastrointestinal (GI) infiltrate is unusual at presentation or relapse of acute myelogenous leukemia (AML). We report a case of acute myelogenous leukemia (FAB‐M4) whose isolated relapse presented as a bleeding gastric ulcer. The patient was a 30‐year‐old male who had been diagnosed to have AML in June 1988. While in third complete remission, he underwent a sibling allogeneic HLA‐matched bone marrow transplant. Five months after transplantation, he was readmitted for pneumonia. While in the hospital, he had an episode of upper GI bleeding. The endoscopy revealed a leukemic gastric ulcer, with morphology and immunophenotyping identical to his initial AML. There was no evidence of leukemia in the blood or bone marrow. Although different types of leukemic infiltrates have been recognized at post‐mortem examination, our case is unique because AML presenting as an isolated malignant ulcer has not been described previously. We conclude that relapsing AML may present as an isolated gastric ulcer and suggest that any suspicious lesion on upper GI endoscopy should be biopsied after aggressive platelet support.
KW - acute leukemia
KW - bleeding gastric ulcer
KW - relapse
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U2 - 10.1002/ajh.2830370412
DO - 10.1002/ajh.2830370412
M3 - Article
C2 - 1858786
AN - SCOPUS:0025915734
SN - 0361-8609
VL - 37
SP - 270
EP - 273
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 4
ER -