human
***task***
the task is to summarize an input biomedical literature in six sentences

***input***
the input is a biomedical literature

***output***
the output is the summary of an input biomedical literature in six sentences

***documentation***

***examples***

input: a 28 - year - old woman with a history of acute myelogenous leukemia ( aml ) , aggressively treated with 3 bone marrow transplants and multiple regimens of chemotherapy targeting aml , presented to the emergency room with abdominal pain and fever . computed tomography ( ct ) of the abdomen and pelvis revealed pneumatosis of the transverse colon and a small amount of free air adjacent to the lesser sac ( figure 1 ) . the patient 's history of aml was significant for extensive tumor burden and uterine involvement , causing hydronephrosis and renal failure , despite her multiple chemotherapy regimens . our surgical examination showed the patient to be alert , afebrile , and hemodynamically stable , with mild tenderness on palpation of the abdomen . our laboratory examination revealed a white blood cell count of 5.4 ; hemoglobin , 9.3 ; and platelets , 38 . of note , a bone marrow biopsy performed 1 week earlier showed hypocellular marrow , without morphologic or immunophenotypic evidence of acute leukemia . we noted diffuse pneumatosis and thickened , ischemic - appearing transverse colon extending to the splenic flexure . we then performed an extended right colectomy , including the remaining right colon and transverse colon , with a long hartmann pouch and end ileostomy . our pathologic examination demonstrated extensive pneumatosis intestinalis ( figure 2 , hematoxylin and eosin [ h & e ] , 40x ) , and a focus of myeloid ( granulocytic ) sarcoma at the ileal resection margin . the ileal resection margin contained a small ( 0.9 cm x 0.5 cm ) serosal nodule composed of an infiltrate of granulocytic precursor cells . those cells ranged from the most immature blast forms to mature neutrophils - a spectrum consistent with granulocytic sarcoma ( also called myeloid sarcoma or chloroma ) . on the serosal surface , cells formed a discrete mass ; they did not involve either the muscular wall or the mucosa of the small bowel . immuno - histochemistry testing of the mass stained positively for the immature myeloid markers cd 34 ( figure 3 , 40x ) and cd 117 ( figure 4 , 40x ) ; the pattern matched the patient 's original diagnostic bone marrow biopsy findings for aml from 3 years previously . this tissue manifestation of aml represented a relapse of the patient 's original disease process . frequently , it is found concurrently with aml , but can also be found as an isolated lesion in patients who do not have aml . extramedullary sites include the skin , lymph nodes , central nervous system , reproductive organs , and gastrointestinal ( gi ) tract . 1 - 5,9,10 . our patient represents an unusual complication of aml , namely , granulocytic sarcoma in multiple extramedullary sites , including the uterus , vagina , and colon . most reported cases of granulocytic sarcoma ( 69 % ) are reported in patients with a single focus of disease or an isolated mass 2 . in up to 36 % of women with aml , autopsy shows genital tract involvement 4 , but only a handful of case reports have documented antemortem diagnosis 7,8 . reports in the literature documenting the involvement of the colon are uncommon ; and even more rare when additional sites are included . in the gi tract , the small bowel is more frequently involved than the colon ; rates of small bowel involvement are estimated at 10 % 1,2 . large bowel involvement is evident primarily in case reports 6,9,10 . when planning surgery for neutropenic patients with typhilitis , particularly those with aml , granulocytic sarcoma should be considered in the differential diagnosis . involvement of the colon may be more frequent than reported , given that typhilitis may be treated without surgery in a select population of patients . moreover , involvement of the colon may be mistaken for more routine pathologic findings of colonoscopic evaluations or may be misdiagnosed by histologic tests 3,6 . however , a month after surgery , she was readmitted for fever , neutropenia , and pneumonia -- which resulted in her death about 1 month later ( that is , 2 months postoperatively ) .
output:

agent
there is limited literature documenting granulocytic sarcoma of the colon . we report a case of a 28 year - old female with a colonic granulocystic sarcoma of the colon as a complication of aml , as it is an important consideration with surgical management of typhilitis .
***task***
the task is to summarize an input biomedical literature in six sentences

***input***
the input is a biomedical literature

***output***
the output is the summary of an input biomedical literature in six sentences

***documentation***

***examples***

input: a 28 - year - old woman with a history of acute myelogenous leukemia ( aml ) , aggressively treated with 3 bone marrow transplants and multiple regimens of chemotherapy targeting aml , presented to the emergency room with abdominal pain and fever . computed tomography ( ct ) of the abdomen and pelvis revealed pneumatosis of the transverse colon and a small amount of free air adjacent to the lesser sac ( figure 1 ) . the patient 's history of aml was significant for extensive tumor burden and uterine involvement , causing hydronephrosis and renal failure , despite her multiple chemotherapy regimens . our surgical examination showed the patient to be alert , afebrile , and hemodynamically stable , with mild tenderness on palpation of the abdomen . our laboratory examination revealed a white blood cell count of 5.4 ; hemoglobin , 9.3 ; and platelets , 38 . of note , a bone marrow biopsy performed 1 week earlier showed hypocellular marrow , without morphologic or immunophenotypic evidence of acute leukemia . we noted diffuse pneumatosis and thickened , ischemic - appearing transverse colon extending to the splenic flexure . we then performed an extended right colectomy , including the remaining right colon and transverse colon , with a long hartmann pouch and end ileostomy . our pathologic examination demonstrated extensive pneumatosis intestinalis ( figure 2 , hematoxylin and eosin [ h & e ] , 40x ) , and a focus of myeloid ( granulocytic ) sarcoma at the ileal resection margin . the ileal resection margin contained a small ( 0.9 cm x 0.5 cm ) serosal nodule composed of an infiltrate of granulocytic precursor cells . those cells ranged from the most immature blast forms to mature neutrophils - a spectrum consistent with granulocytic sarcoma ( also called myeloid sarcoma or chloroma ) . on the serosal surface , cells formed a discrete mass ; they did not involve either the muscular wall or the mucosa of the small bowel . immuno - histochemistry testing of the mass stained positively for the immature myeloid markers cd 34 ( figure 3 , 40x ) and cd 117 ( figure 4 , 40x ) ; the pattern matched the patient 's original diagnostic bone marrow biopsy findings for aml from 3 years previously . this tissue manifestation of aml represented a relapse of the patient 's original disease process . frequently , it is found concurrently with aml , but can also be found as an isolated lesion in patients who do not have aml . extramedullary sites include the skin , lymph nodes , central nervous system , reproductive organs , and gastrointestinal ( gi ) tract . 1 - 5,9,10 . our patient represents an unusual complication of aml , namely , granulocytic sarcoma in multiple extramedullary sites , including the uterus , vagina , and colon . most reported cases of granulocytic sarcoma ( 69 % ) are reported in patients with a single focus of disease or an isolated mass 2 . in up to 36 % of women with aml , autopsy shows genital tract involvement 4 , but only a handful of case reports have documented antemortem diagnosis 7,8 . reports in the literature documenting the involvement of the colon are uncommon ; and even more rare when additional sites are included . in the gi tract , the small bowel is more frequently involved than the colon ; rates of small bowel involvement are estimated at 10 % 1,2 . large bowel involvement is evident primarily in case reports 6,9,10 . when planning surgery for neutropenic patients with typhilitis , particularly those with aml , granulocytic sarcoma should be considered in the differential diagnosis . involvement of the colon may be more frequent than reported , given that typhilitis may be treated without surgery in a select population of patients . moreover , involvement of the colon may be mistaken for more routine pathologic findings of colonoscopic evaluations or may be misdiagnosed by histologic tests 3,6 . however , a month after surgery , she was readmitted for fever , neutropenia , and pneumonia -- which resulted in her death about 1 month later ( that is , 2 months postoperatively ) .
output:
