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Obstructive Jaundice as Initial Presentation of Acute Myeloid Leukemia

Geetha Narayanan, Anoop TM, Reshmi CP, Priya Mary Jacob, Rekha Nair


Introduction:Myeloid sarcoma is a rare extramedullary manifestation of Acute myeloid leukemia(AML). Primary involvement of the biliary tract with myeloid sarcoma is very rare.

Case Presentation:A 29 year old man presented with obstructive jaundice. Magnetic Resonance cholangiopancreatography showed intrahepatic biliary radicle dilatation involving both lobes of liver. There was a mass lesion involving the common hepatic duct, cystic duct and proximal common bile duct. He underwent laparotomy and excision of  the mass,  cholecystectomy and  hepatojejunostomy for a mistaken diagnosis of cholangiocarcinoma.  The histopathology was suggestive of myeloid sarcoma. Subsequent bone marrow examination showed AML.  He received chemotherapy for AML and continues to be in remission at 2 years.

Conclusion:Isolated biliary involvement by myeloid  sarcoma is extremely rare and may be misdiagnosed as  as cholangitis or cholecystitis or as cholangiocarcinoma. Biliary myeloid  sarcoma should also be included in the differential diagnosis of patients with obstructive jaundice and investigated for AML.


Myeloid sarcoma; AML; Obstructive jaundice; IHBRD

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