Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain

Hou, Xuewen; Du, Longting; Yu, Haitao; Zhang, Xiaojin

doi:10.18632/oncotarget.21905

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…Similar results were identified based upon 10 cases with a more advanced imaging protocol [20]. Moreover, the ADC value increases after therapy [20]. In the present study, the mean ADC value was slightly higher than reported, yet with most a diffusion restriction pattern.…”

Section: Discussionsupporting

confidence: 90%

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Clinical and imaging features of myeloid sarcoma: a German multicenter study

et al. 2019

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BackgroundMyeloid sarcoma (MS), also known as chloroma, is an extramedullary manifestation of malignant primitive myeloid cells. Previously, only small studies investigated clinical and imaging features of MS. The purpose of this study was to elucidate clinical and imaging features of MS based upon a multicenter patient sample.MethodsPatient records of radiological databases of 4 German university hospitals were retrospectively screened for MS in the time period 01/2001 and 06/2019. Overall, 151 cases/76 females (50.3%) with a mean age of 55.5 ± 15.1 years and 183 histopathological confirmation or clinically suspicious lesions of MS were included into this study. The underlying hematological disease, localizations, and clinical symptoms as well as imaging features on CT and MRI were investigated.ResultsIn 15 patients (9.9% of all 151 cases) the manifestation of MS preceded the systemic hematological disease. In 43 cases (28.4%), first presentation of MS occurred simultaneously with the initial diagnosis of leukemia, and 92 (60.9%) patients presented MS after the initial diagnosis. In 37 patients (24.5%), the diagnosis was made incidentally by imaging. Clinically, cutaneous lesions were detected in 35 of 151 cases (23.2%). Other leading symptoms were pain (n = 28/151, 18.5%), neurological deficit (n = 27/151, 17.9%), swelling (n = 14/151, 9.3%) and dysfunction of the affected organ (n = 10/151, 6.0%). Most commonly, skin was affected (n = 30/151, 16.6%), followed by bone (n = 29/151, 16.0%) and lymphatic tissue (n = 21/151, 11.4%). Other localizations were rare. On CT, most lesions were homogenous. On T2-weighted imaging, most of the lesions were hyperintense. On T1-weighted images, MS was hypointense in n = 22/54 (40.7%) and isointense in n = 30/54 (55.6%). A diffusion restriction was identified in most cases with a mean ADC value of 0.76 ± 0.19 × 10− 3 mm2/s.ConclusionsThe present study shows clinical and imaging features of MS based upon a large patient sample in a multicenter design. MS occurs in most cases meta-chronous to the hematological disease and most commonly affects the cutis. One fourth of cases were identified incidentally on imaging, which needs awareness of the radiologists for possible diagnosis of MS.

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Section: Discussionsupporting

confidence: 90%

“…So, it was reported that most MS lesions showed a diffusion restriction with up to 96% of cerebral lesions [10]. Similar results were identified based upon 10 cases with a more advanced imaging protocol [20]. Moreover, the ADC value increases after therapy [20].…”

Section: Discussionmentioning

confidence: 52%

Clinical and imaging features of myeloid sarcoma: a German multicenter study

et al. 2019

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“…A follow-up MRI scan confirmed no evidence of residual or recurrent local disease. 33 In another retrospective study, Hou et al 34 used several modes of MRI to assess patient response to 2 courses of induction chemotherapy, followed by 4 courses of consolidation chemotherapy. In cases of complete remission, MS lesions turned into hypointense cavities on T2w/FLAIR, diffusion-weighted, and contrast-enhanced T1w imaging.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Myeloid Sarcoma: A Primer for Radiologists

Chiu

Yoon

Tirumani

et al. 2023

J Comput Assist Tomogr

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Myeloid sarcoma (MS) is a rare extramedullary neoplasm that can present in association with acute myeloid leukemia, most commonly in children younger than 15 years. This unique extramedullary malignancy may involve a variety of different organ systems and can present following, preceding, simultaneous with, or in insolation to acute myeloid leukemia. Common areas of extramedullary involvement include soft tissues, bones, lymph nodes, and the peritoneum. Imaging plays a critical role in the diagnosis and management of MS, with commonly used modalities including positron emission tomography-computed tomography, magnetic resonance imaging, computerized tomography, and ultrasound. The purpose of this review article is to provide radiologists with a comprehensive guide summarizing the relevant imaging and clinical features of MS, with emphasis on the role of imaging in the diagnosis, treatment, and follow-up of patients with MS. The relevant pathophysiology, epidemiology, clinical presentations, and differential diagnosis of MS will be reviewed. The relevance of different imaging modalities in diagnosis, monitoring of treatment response, and assessment of treatment-related complications will also be outlined. Through summarizing these topics, this review article aims to provide radiologists with a guide for understanding the existing knowledge of MS in the literature and the current role of imaging in the management of this unique malignancy.

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