Radiologic Manifestations of Granulocytic Sarcoma in Adult Leukemia

Abstract

In patients in our study, the clinical and radiologic manifestations of granulocytic sarcoma were variable and occurred most commonly as disease progression in acute myeloid leukemia (73% of the patients). Granulocytic sarcoma lesions were multiple soft-tissue masses with variable enhancement, recurring in nearly 50% of patients at different sites and points of time during the course of the disease. Lesions in the central nervous system, subcutaneous tissues, and genitourinary system accounted for nearly 52% of all lesions. In general, granulocytic sarcoma masses were isodense to muscle on CT scans, and isointense and hyperintense (mild to moderate) on T1- and T2-weighted MR images, respectively. The presence of peripheral rim enhancement with hypodense or hypointense centers on T1-weighted images may, however, mimic an abscess.

Necrotic intramuscular chloroma with infection: magnetic resonance imaging features

“…There are also cases that mimic an abscess. 5 As in the current case, there have been no cases in which the strongly hyperintense SI was present inside concurrently with a necrotic center. There are also no cases in which there is a concurrent infection of the necrotic portion.…”

“…In cases in which there is an intramuscular location, a differential diagnosis from myositis can be diffi cult. 1,4,5 Magnetic resonance imaging (MRI) of chloroma shows an isointense signal intensity (SI) on T1-weighted images. On T2-weighted images, it has a mildly hyperintense SI.…”

Pineal region myeloid sarcoma

“…4 Although infrequent, there are reports of intracranial myeloid sarcomas from various locations including basal ganglia, 5 cranium/dura, 6 cerebellopontine angle, 7 and cerebral hemisphere. 8 Myeloid sarcoma has a poor prognosis. 9 The diagnosis often heralds an impending blast crisis, even in patients thought to be in remission.…”

An unusual cause of persistent headache: Chloroma (2008: 2b)

“…The green colour is due to the presence of myeloperoxidase. However not all tumours are green in colour and since 30% are white, grey or brown instead of green, the term granulocytic sarcoma has been proposed [1].…”