MDCT Imaging Findings of Extramedullary Granulocytic Sarcoma of the Heart

Abstract

Granulocytic sarcoma, also known as chloroma, is an uncommon tumor typically seen in patients with acute myelogenous leukemia (AML). Extramedullary cardiac involvement of granulocytic sarcoma is rare and there is a paucity of information regarding its multidetector computed tomography (MDCT) imaging appearance. We present a case of extramedullary granulocytic sarcoma of the heart detected on MDCT in a young adult male with AML. An understanding of how extramedullary granulocytic sarcoma of the heart appears on MDCT may decrease or prevent delays in diagnosing this uncommon, although important, complication from AML.

CT and MRI evaluation of cardiac complications in patients with hematologic diseases: a pictorial review

“…In autopsy reports of patients with AML, myocardial involvement was present in less than 1 % [18,20]. Patients with GS that involve the heart may be asymptomatic until the end stage or experience various and nonspecific symptoms depending on the location of GS involvement within the heart [17][18][19]21]. Thus, it is difficult to reach an early diagnosis of GS exclusively based on clinical signs and symptoms.…”

“…GS commonly arise in lymph nodes, periosteum, bone, oral mucosa, skin, and other soft tissue; cardiac involvement is very rare [13,[16][17][18]. Leukemia accounts for approximately 4 % of secondary tumors involving the heart [16,17,19]. In autopsy reports of patients with AML, myocardial involvement was present in less than 1 % [18,20].…”

“…d Specimen of this thrombus with pale yellow friable marginal calcification Int J Cardiovasc Imaging mass [22,23]. On CT, it appears as a lobulated mass with a similar or slightly higher density than the surrounding myocardium characterized by uniform, homogeneous enhancement after contrast injection; in addition, calcification is rare [15,17].…”

“…However, GS can also occur in up CCT cardiac computed tomography, CMRI cardiac magnetic resonance imaging Int J Cardiovasc Imaging to 35 % of cases when there is no evidence of leukemia or bone marrow involvement [12,15]. GS commonly arise in lymph nodes, periosteum, bone, oral mucosa, skin, and other soft tissue; cardiac involvement is very rare [13,[16][17][18]. Leukemia accounts for approximately 4 % of secondary tumors involving the heart [16,17,19].…”

“…Thus, it is difficult to reach an early diagnosis of GS exclusively based on clinical signs and symptoms. Therefore, the use of imaging modalities during evaluation is important to diagnose GS [17,18,21].…”