대한흉부영상의학회 Korean Society of Thoracic Radiology

Discussion

Diagnosis With Brief Discussion

Diagnosis

Myeloid sarcoma

Radiologic Findings

Chest radiograph shows a huge mass in posterior mediastinum.
Chest CT shows huge soft tissue mass encasing descending thoracic aorta in posterior mediastinum extending into retrocrural space and retroperitoneum. PET-CT image demonstrates a huge mass in the posterior mediastinum to the retrocrural space with moderate homogenous hypermetabolism.

US guided biopsy was done and pathology confirmed myeloid sarcoma.

Brief Review

Myeloid sarcoma also called granulocytic sarcoma or chloroma is an extramedullary tumor of immature granulocytic cells. It is a rare disease entity, and mostly accompanied by acute myeloid leukemia. In some rare cases, it is detected before clinical signs of leukemia or other diseases.
Intrathoracic myeloid sarcomas are rare. The mediastinum is the most common site of involvement. Less commonly affected are the lungs, pleura, pericardium, and hila.
Imaging findings are nonspecific. Radiologically, mediastinal myeloid sarcomas are often misdiagnosed as malignant lymphoma. Lung manifestations consist of alveolar opacities, nodules, or interstitial septal lines. Pleural effusions can be associated with homogeneous and well-circumscribed pleural masses or nodules. In general, myeloid sarcoma masses were isodense to muscle on CT scans, and isointense and hyperintense (mild to moderate) on T1- and T2-weighted MR images, respectively.

References

1.Guermazi A, Feger C, Rousselot P et al. Granulocytic Sarcoma (Chloroma): Imaging Findings in Adults and Children. AJR 2002;178:319–325
2.Yilmaz AF,Saydam G, Sahin F, Baran Y. Granulocytic sarcoma: a systematic review. Am J Blood Res 2013;3(4):265-270
3.Ooi GC, Chim CS, Khong PL et al. Radiologic Manifestations of Granulocytic Sarcoma in Adult Leukemia. AJR 2001;176:1427–1431

Keywords

Mediastinum, Malignant tumor,