Granulocytic sarcoma presenting in two patients without leukemia / 대한내과학회지

Granulocytic sarcoma (GS) is a rare extramedullary tumor composed of immature myeloid precursor cells. GS is associated with acute or chronic myeloid leukemia; it has rarely been reported in non-leukemic patients. We report two cases of GS with unusual presentations; neither had bone marrow involvement. The first case was a GS presenting with multiple intra-abdominal masses in a 43-year-old man. Computed tomography (CT) of the abdomen showed masses in the small bowel and right adrenal gland. The second case was a patient with a GS presenting with symptoms of spinal cord compression in a 32-year-old man. Magnetic resonance imaging (MRI) showed an extradural mass in the spinal canal at the T3-T5 levels. Blood smear and bone marrow studies were normal. These cases show that GS should be included in the differential diagnosis of intra-abdominal masses and extradural spinal cord tumors, even in the absence of leukemia.

Hypertriglyceridemia-induced acute pancreatitis in pregnancy: A case report / 대한내과학회지

Hypertriglyceridemia-induced pancreatitis is a rare, but serious, complication of pregnancy. We report a case of acute pancreatitis associated with type V hyperlipoproteinemia in pregnancy. A 36-year-old primigravida was admitted at 16 weeks of gestation with severe abdominal pain. Chemical analysis showed high serum pancreatic enzymes and very high serum triglyceride. Abdominal magnetic resonance imaging (MRI) showed diffuse swelling of the pancreas and a peripancreatic fluid collection. A diagnosis of acute pancreatitis with type V hyperlipoproteinemia was made. She recovered from the acute pancreatitis with conservative management and the serum triglyceride decreased rapidly with dietary restriction of fat, insulin/glucose, fenofibrate, and omega-3. We review the management of hypertriglyceridemia-induced acute pancreatitis in pregnancy.