Background
Myeloid sarcoma (MS), also known as granulocytic sarcoma or chloroma, is a solid tumor of extramedullary localization composed of malignant primitive myeloid cells. The purpose of the study was to identify clinical and imaging features in a large patient sample.
Patients and methods
Overall, 71 cases (34 females (47.9%) and 37 males (52.1%) with a median age of 56 (± 16 years) of histopathologically confirmed myeloid sarcoma were included into this study. The underlying hematological disease, occurrence, localizations and clinical symptoms as well as imaging features on computed tomography and magnetic resonance imaging were investigated.
Results
In 4 cases (5.63%) the manifestation of MS preceded the systemic hematological disease by a mean value of 3.8 ± 2.1 months. In 13 cases, first presentation of MS occurred simultaneously with the initial diagnosis of leukemia, and 51 patients presented MS after the initial diagnosis of the underlying malignancy with a mean latency of 39.8 ± 44.9 SD months. The visceral soft tissue was affected in 26 cases, followed by the cutis/subcutis was affected in 21 cases. Further localizations were bones (n = 13), central nervous system (n = 9), lymph nodes (n = 4) and visceral organs (n = 9).
Conclusions
MS is a rare complication of several hematological malignancies, predominantly of acute myeloid leukemia, which can affect any part of the body. In most cases it occurs after the diagnosis of the underlying malignancy, and affects frequently the cutis and subcutis.
Cardiac hematological malignancies (CHMs) are rare entities and comprise lymphoma, leukemic infiltration, and extramedullary manifestation of multiple myeloma. The aim of this work is to summarize typical growth patterns, imaging features, and outcome parameters of CHM. Overall, 12 cases from 4 centers were reviewed retrospectively together with 604 cases from the literature. Cardiac hematological malignancies were mainly represented by B-cell lymphoma (70.0%). Other entities were rarer. Almost half of the patients showed involvement of multiple cardiac structures. Most commonly right atrium, right ventricle, pericardium, left atrium, and left ventricle were affected in decreased order of frequency. Cardiac hematological malignancies manifested with 3 growth patterns: intracaval masses, heart wall infiltration, and pericardial effusion. Several subtypes of CHM tended to present with different patterns. Clinical presentation is unspecific-frequent signs were dyspnea (54.6%), arrhythmias (30.5%), and thoracic pain (18.5%). Outcome of CHM is poor with mean survival of 283.6 days for leukemias, 260.1 days for T-cell non-Hodgkin lymphoma (NHL), 217.9 days for B-cell NHL, and 155.5 days for multiple myeloma.
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