Evidence map›Paper›PMID 30352989›Full record

ArticleThe American journal of case reports2018

A Case of Granulocytic Sarcoma or Extramedullary Acute Myelomonocytic Leukemia of the Gallbladder.

Erik A Holzwanger, Zainab Alam, Emily Hsu, Andrew Hsu, Mark Mangano, Deirdre L Kathman

Open access · greenAbstract readCase Reports
In one paragraph

Article in The American journal of case reports, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.7field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Erik A HolzwangerDepartment of Internal Medicine, UMass Memorial Medical Center, Worcester, MA, USA.
Zainab AlamDepartment of Internal Medicine, UMass Memorial Medical Center, Worcester, MA, USA.
Emily HsuDepartment of Internal Medicine, UMass Memorial Medical Center, Worcester, MA, USA.
Andrew HsuDepartment of Internal Medicine, UMass Memorial Medical Center, Worcester, MA, USA.
Mark ManganoDepartment of Pathology, Milford Regional Medical Center, Milford, MA, USA.
Deirdre L KathmanDepartment of Pulmonary Critical Care Medicine, Milford Regional Medical Center, Milford, MA, USA.
UMass Memorial Medical Center · USRegional Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND Granulocytic sarcoma, or 'chloroma,' due to extramedullary acute myeloid leukemia (AML) or due to acute myelomonocytic leukemia (AML M5), is rare and is associated with a poor prognosis. This report is of a case of granulocytic sarcoma of the gallbladder and describes the approach to diagnosis and treatment. CASE REPORT A 74-year-old Hispanic woman from Ecuador presented to the emergency department with a five-day history of fever, jaundice, and right upper quadrant abdominal pain. The right upper quadrant ultrasound showed a thickened gallbladder wall with cholelithiasis, a positive sonographic Murphy sign, and marked dilatation of the common bile duct, which was up to 17 mm in diameter. Endoscopic retrograde cholangiopancreatography (ERCP) showed purulence and a stone in the common bile duct, which was removed. She underwent laparoscopic cholecystectomy which identified gangrenous cholecystitis. Despite cholecystectomy and treatment with broad-spectrum antibiotics, she remained febrile with a leukocytosis of up to 80,000 cells/µL. Histopathology of the gallbladder showed infiltrating myeloblasts within the mucosa, submucosa, and muscularis consistent with a granulocytic sarcoma associated with gangrenous cholecystitis due to cholelithiasis. Immunohistochemistry, using a panel of antibodies to CD33, CD68, HLA-DR, and lysozyme, supported the diagnosis of granulocytic sarcoma or extramedullary acute myelomonocytic leukemia (AML M5). CONCLUSIONS A rare case of an extramedullary hematologic malignancy, granulocytic sarcoma of the gallbladder is presented, which highlights the importance of timely diagnosis and treatment, due to the high mortality rate associated with granulocytic sarcoma, or extramedullary AML.

Indexed as

AgedDiagnosis, DifferentialFemaleGallbladder NeoplasmsHumansLeukemia, Myelomonocytic, AcuteSarcoma, Myeloid

Identifiers

PMID30352989
PMCPMC6213823
OpenAlexW2898278285

What OpenQuestion holds

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LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.