title: Nonleukemic granulocytic sarcoma in the bile duct: a case report.
abstract: Granulocytic sarcoma (GS) is an extramedullary tumor composed of immature myeloid cells, typically occurring during the course of acute myelogenous leukemia. Non-leukemic GS, that is, GS with no evidence of overt leukemia and no previous history of leukemia, is very rare, and even more unusual is nonleukemic GS of the bile duct. We report a case of nonleukemic GS of the bile duct. The patient was initially misdiagnosed as a bile duct carcinoma arising in the hilum of the liver (so-called Klatskin tumor), and received a right lobectomy of the liver. Histological examination of the tumor yielded the diagnosis of GS, and the bone marrow biopsy did not show any evidence of leukemia. Considering the risk of subsequent development of overt leukemia, the patient was treated with two cycles of combination chemotherapy as used in the cases of acute myelogenous leukemia. To date, he has remained free of disease 15 months after treatment.
authors.affiliation: Department of Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul, Korea.
authors.forename: Hyun Woo
authors.initials: HW
authors.lastname: Kim
authors.forename: Seong-Jun
authors.initials: SJ
authors.lastname: Choi
authors.forename: Je-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.forename: Taeg Soo
authors.initials: TS
authors.lastname: Kim
authors.forename: Yong Gil
authors.initials: YG
authors.lastname: Kim
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Kang
authors.forename: Jooryng
authors.initials: J
authors.lastname: Huh
authors.forename: Kwang Min
authors.initials: KM
authors.lastname: Park
authors.forename: Kyoo-Hyung
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D001650:Bile Duct Neoplasms / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000378:metabolism; D001652:Bile Ducts / Q000737:chemistry / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D017493:Leukocyte Common Antigens / Q000032:analysis; D008297:Male; D009195:Peroxidase / Q000032:analysis; D011860:Radiography, Abdominal; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D009195:Peroxidase; D017493:Leukocyte Common Antigens