title: A case of steroid-dependent myeloid granulocytic sarcoma masquerading as Crohn's disease.
abstract: Small bowel tumors and Crohn's disease are common causes of small bowel obstruction. Early stage neoplasms can easily be mistaken for Crohn's disease. Therefore, thorough work-ups including imaging studies and endoscopic evaluation with biopsies are critical for accurate diagnosis. Here we report a case of an otherwise healthy female with progressive onset of multiple, recurrent obstructive symptoms secondary to terminal ileal narrowing who was referred for management of steroid-dependent Crohn's disease. After thorough evaluation, the diagnosis was revised to myeloid granulocytic sarcoma involving the terminal ileum. In this case, a delay in diagnosis can be detrimental for prognosis, as myeloid granulocytic sarcoma is highly predictive of underlying acute myeloid leukemia and needs urgent referral for chemotherapy and/or resection.
authors.affiliation: Lola Y Kwan, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14642, United States.
authors.forename: Lola Y
authors.initials: LY
authors.lastname: Kwan
authors.forename: Stephan R
authors.initials: SR
authors.lastname: Targan
authors.forename: David Q
authors.initials: DQ
authors.lastname: Shih
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003424:Crohn Disease / Q000175:diagnosis*; D003937:Diagnosis, Differential; D013505:Digestive System Surgical Procedures; D004358:Drug Therapy; D005260:Female; D006801:Humans; D007078:Ileal Neoplasms / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D013256:Steroids; D016896:Treatment Outcome
chemical_list: D013256:Steroids