Gastric Granulocytic Sarcoma as a Localized Blastic Crisis in a Patient With Polycythemia Vera

Abstract

Granulocytic sarcoma is a tumor of immature granulocytic cell that can be found at any organ outside the bone marrow. It has been rarely reported and most cases are associated with leukemia. This report presented a case of granulocytic sarcoma originating from the stomach of a polycythemia vera patient. He was a 66-year-old Thai patient who passed melena for many times in 2 days. Two years prior this presentation, he had been diagnosed as having polycythemia vera and treated with occasional phlebotomy and hydroxyurea. The gastroscopy showed multiple sessile polyps at gastric body of which the pathology showed diffuse infiltration by myeloblasts; the tumor cells diffusely marked with LCA, CD34, CD117, sparsely marked with MPO, compatible with blastic phase of myeloproliferative neoplasm. The diagnosis of gastric granulocytic sarcoma or localized blastic transformation at the stomach with underlying polycythemia vera was concluded.