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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Extramedullary leukemic tumors (EML)
- Extramedullary myeloblastoma, extramedullary myeloid cell tumors (EMMCT)
Synonyms
- Myeloid sarcoma, granulocytic sarcoma, chloroma
- Leukemic masses 1st described in 1811
- Chloroma coined in 1853
- Renamed granulocytic sarcoma in 1966
- Now most commonly termed myeloid sarcoma
- Myeloid sarcoma, granulocytic sarcoma, chloroma
Definitions
- Solid tumor of myeloblasts/myelocytes/promyelocytes
- In patients with myeloproliferative disorder
- Multiple other intracranial manifestations of leukemia/treatment complications
- Acute methotrexate toxicity
- Posterior reversible encephalopathy syndrome (PRES)
- Invasive fungal infection
- Cavernous malformations after radiation therapy
- Posttransplantation lymphoproliferative disease (PTLD) after bone marrow transplantation
- Venous thrombosis associated with L-asparaginase
- Spontaneous multifocal intraparenchymal hemorrhage in severe hyperleukocytosis
- Vasculitis
- Primary manifestation of leukemia
- Secondary to treatment (transretinoic acid)
- Secondary to infection (e.g., Aspergillus)
- Solid tumor of myeloblasts/myelocytes/promyelocytes
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Meyer HJ et al: Radiological and clinical patterns of myeloid sarcoma. Radiol Oncol. 53(2):213-8, 2019
- Almond LM et al: Myeloid sarcoma: presentation, diagnosis, and treatment. Clin Lymphoma Myeloma Leuk. 17(5):263-7, 2017
- Hou X et al: Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain. Oncotarget. 8(60):102581-9, 2017
- Chaudhry AA et al: Qualitative assessment of diffusion weighted imaging and susceptibility weighted imaging of myeloid sarcoma involving the brain. j Comput Assist Tomogr. 40(1):61-6, 2016
- Bhojwani D et al: Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. J Clin Oncol. 32(9):949-59, 2014
- Morioka S et al: Effects of chemotherapy on the brain in childhood: diffusion tensor imaging of subtle white matter damage. Neuroradiology. 55(10):1251-7, 2013
- Spataro R et al: Neurological picture. Petechial brain haemorrhages in acute lymphoblastic leukaemia. J Neurol Neurosurg Psychiatry. 84(8):908, 2013
- Faraci M et al: Magnetic resonance imaging in childhood leukemia survivors treated with cranial radiotherapy: a cross sectional, single center study. Pediatr Blood Cancer. 57(2):240-6, 2011
- Dicuonzo F et al: Posterior reversible encephalopathy syndrome associated with methotrexate neurotoxicity: conventional magnetic resonance and diffusion-weighted imaging findings. J Child Neurol. 24(8):1013-8, 2009
- Koenig MK et al: Central nervous system complications of blastic hyperleukocytosis in childhood acute lymphoblastic leukemia: diagnostic and prognostic implications. J Child Neurol. 23(11):1347-52, 2008
- Hakyemez B et al: Parlak M. Intracranial myeloid sarcoma: conventional and advanced MRI findings. Br J Radiol. 80(954):e109-12, 2007
- Denier C et al: Spectrum and prognosis of neurologic complications after hematopoietic transplantation. Neurology. 67(11):1990-7, 2006
- Glass J: Neurologic complications of lymphoma and leukemia. Semin Oncol. 33(3):342-7, 2006
- Nikolic B et al: CT changes of an intracranial granulocytic sarcoma on short-term follow-up. AJR Am J Roentgenol. 180(1):78-80, 2003
- Ahn JY et al: Meningeal chloroma (granulocytic sarcoma) in acute lymphoblastic leukemia mimicking a falx meningioma. J Neurooncol. 60(1):31-5, 2002
- Guermazi A et al: Granulocytic sarcoma (chloroma): imaging findings in adults and children. AJR Am J Roentgenol. 178(2):319-25, 2002
- Lee B et al: Granulocytic sarcoma of the temporal bone. AJNR Am J Neuroradiol. 23(9):1497-9, 2002
- Chen CY et al: Childhood leukemia: central nervous system abnormalities during and after treatment. AJNR Am J Neuroradiol. 17(2):295-310, 1996
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References
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Pathology
Diagnostic Checklist
TERMINOLOGY
Abbreviations
- Extramedullary leukemic tumors (EML)
- Extramedullary myeloblastoma, extramedullary myeloid cell tumors (EMMCT)
Synonyms
- Myeloid sarcoma, granulocytic sarcoma, chloroma
- Leukemic masses 1st described in 1811
- Chloroma coined in 1853
- Renamed granulocytic sarcoma in 1966
- Now most commonly termed myeloid sarcoma
- Myeloid sarcoma, granulocytic sarcoma, chloroma
Definitions
- Solid tumor of myeloblasts/myelocytes/promyelocytes
- In patients with myeloproliferative disorder
- Multiple other intracranial manifestations of leukemia/treatment complications
- Acute methotrexate toxicity
- Posterior reversible encephalopathy syndrome (PRES)
- Invasive fungal infection
- Cavernous malformations after radiation therapy
- Posttransplantation lymphoproliferative disease (PTLD) after bone marrow transplantation
- Venous thrombosis associated with L-asparaginase
- Spontaneous multifocal intraparenchymal hemorrhage in severe hyperleukocytosis
- Vasculitis
- Primary manifestation of leukemia
- Secondary to treatment (transretinoic acid)
- Secondary to infection (e.g., Aspergillus)
- Solid tumor of myeloblasts/myelocytes/promyelocytes
IMAGING
General Features
CT Findings
MR Findings
Nuclear Medicine Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
- Meyer HJ et al: Radiological and clinical patterns of myeloid sarcoma. Radiol Oncol. 53(2):213-8, 2019
- Almond LM et al: Myeloid sarcoma: presentation, diagnosis, and treatment. Clin Lymphoma Myeloma Leuk. 17(5):263-7, 2017
- Hou X et al: Use of magnetic resonance imaging for diagnosis and after treatment of patients with myeloid sarcoma of the brain. Oncotarget. 8(60):102581-9, 2017
- Chaudhry AA et al: Qualitative assessment of diffusion weighted imaging and susceptibility weighted imaging of myeloid sarcoma involving the brain. j Comput Assist Tomogr. 40(1):61-6, 2016
- Bhojwani D et al: Methotrexate-induced neurotoxicity and leukoencephalopathy in childhood acute lymphoblastic leukemia. J Clin Oncol. 32(9):949-59, 2014
- Morioka S et al: Effects of chemotherapy on the brain in childhood: diffusion tensor imaging of subtle white matter damage. Neuroradiology. 55(10):1251-7, 2013
- Spataro R et al: Neurological picture. Petechial brain haemorrhages in acute lymphoblastic leukaemia. J Neurol Neurosurg Psychiatry. 84(8):908, 2013
- Faraci M et al: Magnetic resonance imaging in childhood leukemia survivors treated with cranial radiotherapy: a cross sectional, single center study. Pediatr Blood Cancer. 57(2):240-6, 2011
- Dicuonzo F et al: Posterior reversible encephalopathy syndrome associated with methotrexate neurotoxicity: conventional magnetic resonance and diffusion-weighted imaging findings. J Child Neurol. 24(8):1013-8, 2009
- Koenig MK et al: Central nervous system complications of blastic hyperleukocytosis in childhood acute lymphoblastic leukemia: diagnostic and prognostic implications. J Child Neurol. 23(11):1347-52, 2008
- Hakyemez B et al: Parlak M. Intracranial myeloid sarcoma: conventional and advanced MRI findings. Br J Radiol. 80(954):e109-12, 2007
- Denier C et al: Spectrum and prognosis of neurologic complications after hematopoietic transplantation. Neurology. 67(11):1990-7, 2006
- Glass J: Neurologic complications of lymphoma and leukemia. Semin Oncol. 33(3):342-7, 2006
- Nikolic B et al: CT changes of an intracranial granulocytic sarcoma on short-term follow-up. AJR Am J Roentgenol. 180(1):78-80, 2003
- Ahn JY et al: Meningeal chloroma (granulocytic sarcoma) in acute lymphoblastic leukemia mimicking a falx meningioma. J Neurooncol. 60(1):31-5, 2002
- Guermazi A et al: Granulocytic sarcoma (chloroma): imaging findings in adults and children. AJR Am J Roentgenol. 178(2):319-25, 2002
- Lee B et al: Granulocytic sarcoma of the temporal bone. AJNR Am J Neuroradiol. 23(9):1497-9, 2002
- Chen CY et al: Childhood leukemia: central nervous system abnormalities during and after treatment. AJNR Am J Neuroradiol. 17(2):295-310, 1996
