Gut Liver.  2007 Dec;1(2):182-185.

Acute Myeloid Leukemia Presenting as Obstructive Jaundice Caused by Granulocytic Sarcoma

• Lee JY
• Lee WS
• Jung MK
• Jeon SW
• Cho CM
• Tak WY
• Kweon YO
• Kim SK
• Choi YH
• Kim JG
• Sohn SK

Abstract

We report a rare case of granulocytic sarcoma infiltrating the bile duct in a patient with acute myeloid leukemia. A 23-year-old man presented with jaundice and weight loss. A peripheral blood smear revealed blast cells, and the results of an examination of bone marrow aspirate were consistent with acute myeloid leukemia. The bilirubin level increased gradually after induction chemotherapy with cytarabine. Magnetic resonance cholangiopancreatography (MRCP) revealed dilatation of the intrahepatic bile ducts and smooth tapering off at the level of the common hepatic bile duct. Endoscopic retrograde cholangiopancreatography (ERCP) also revealed diffuse narrowing of the proximal common hepatic bile duct. Obstructive jaundice resolved after endoscopic nasobiliary drainage. Remission induction chemotherapy with cytarabine and idarubicin was administered, and the patient remained complete hematological remission with normal liver function tests.

Keyword

Leukemia, Myelocytic, Acute; Jaundice, Obstructive; Bile ducts; Retrograde cholangiopancreatography, Endoscopic

MeSH Terms

Bile Ducts
Bile Ducts, Intrahepatic
Bilirubin
Bone Marrow
Cholangiopancreatography, Endoscopic Retrograde
Cholangiopancreatography, Magnetic Resonance
Cytarabine
Dilatation
Drainage
Drug Therapy
Humans
Idarubicin
Induction Chemotherapy
Jaundice
Jaundice, Obstructive*
Leukemia, Myeloid, Acute*
Liver Function Tests
Remission Induction
Sarcoma, Myeloid*
Weight Loss
Young Adult
Bilirubin
Cytarabine
Idarubicin