Obstructive Jaundice with skin involvement - An unusual presentation of Myeloid Sarcoma

Biliary obstruction secondary to malignancy is a common clinical problem. Rarely, biliary obstruction is due to leukemia, and obstructive jaundice in these patients usually presents late in the course of the disease. We present a rare case of a patient who presented with fever, jaundice, and pruritu...

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Bibliographic Details
Published inIndian journal of pathology & microbiology Vol. 66; no. 4; pp. 862 - 864
Main Authors Jeji, Pukhraj S, Patnaik, Swarup K, Behera, Manas K, Narayan, Jimmy, Sahu, Manoj K, Mishra, Debakanta, Singh, Ayaskanta, Pati, Girish K
Format Journal Article
LanguageEnglish
Published India Medknow Publications and Media Pvt. Ltd 01.10.2023
Medknow Publications & Media Pvt. Ltd
Wolters Kluwer Medknow Publications
Subjects
Acute myeloid leukemia
acute myeloid leukemia (aml)
Bile ducts
Bilirubin
Biopsy
Chemotherapy
Immunohistochemistry
Jaundice
Lesions
Leukemia
Magnetic resonance
Malignancy
myeloid sarcoma
obstructive jaundice
Pruritus
Sarcoma
Shoulder
Skin
Skin diseases
Skin lesions
Thigh
Tumors
obstructive jaundice
Acute myeloid leukemia (AML)
myeloid sarcoma
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Summary:Biliary obstruction secondary to malignancy is a common clinical problem. Rarely, biliary obstruction is due to leukemia, and obstructive jaundice in these patients usually presents late in the course of the disease. We present a rare case of a patient who presented with fever, jaundice, and pruritus with multiple nodular swellings in the left shoulder, left thigh, and lower back. Magnetic resonance cholangiopancreatography (MRCP) revealed periampullary mass lesion causing dilated common bile duct (CBD) and intrahepatic bile ducts; hence, endoscopic retrograde cholangiography with plastic stenting was done. Biopsy from the shoulder lesion revealed a mesenchymal tumor, and immunohistochemistry (IHC) confirmed the lesion as myeloid sarcoma. Myeloid sarcoma is an extramedullary tumor, a subtype of acute myeloid leukemia, and presentation as biliary lesions with multiple anatomical sites is very rare. The patient was started on chemotherapy after the normalization of bilirubin. The patient showed improvement of skin lesions and normalization of liver function test (LFT) after 3 weeks of chemotherapy.
ISSN:0377-4929
0974-5130
DOI:10.4103/ijpm.ijpm_1108_21