[Clinical Analysis of Patient with Esophageal Granulocytic Sarcoma Derived from Chronic Myelocytic Leukemia]

Objective: To investigate the diagnosis and treatment of esophageal granulocytic sarcoma derived from chronic myelocytic leukemia (CML).

Methods: The clinical manifestations, diagnosis and treatment of 1 case of esophageal granulocytic sarcoma secondary from chronic myelocytic leukemia were retrospectively analyzed and the related literature was reviewed.

Results: The patient was a 72-year-old woman with poststernal pain accompanied by general weakness. Gastroscopy was performed in a local hospital. At the same time, the increase of peripheral blood leucocytes was obvious. Under gastroscopy, 1.0 cm×0.5 cm irregular protuberance was found at 28 cm from the esophagus to the incisor teeth, and the surface was covered with erosion and a small amount of blood. Pathological results showed that heterotypic lymphoid cell infiltration, cytoplasmic red staining and more neutrophils were seen. Immunohistochemical staining results showed that AE1/AE3, CK5/6 and p63 displayed squamous epithelium (+); atypical lymphoid cells CD20^-, CD23^-, CD3^-, CD5^-, CD79a^-, MP0⁺, Ki-67⁺ (80%) were observed; FISH examination showed positive expression of BCR/ABL. The patient was further examined on myelogran and was diagnosed as chronic myelocytic leukemia with esophageal granulocytic sarcoma. Imatinib was given orally and the patient was followed up in the clinic.

Conclusion: Esophageal granulocytic sarcoma is rare in clinic, its clinical symptoms are not specific. Gastroscopy should be routinely screened for esophageal discomfort, and the esophageal granulocytic sarcoma derived from CML is treated according to the therapeutic regimen of the acute transformation of chronic myelocytic leukemia.