A granulocytic sarcoma (also called myeloid sarcoma and chloroma) is a rare neoplasm comprised of myeloid precursor cells.
It can occur in association with:
- acute myeloid leukaemia (AML)
- chronic myeloid leukaemia (CML)
- othermyeloproliferative disorders such as
It is typically seen is in children with ~ 60% occurring in individuals less than 15 years of age. There is no recognised gender predilection.
Granulocytic sarcoma may develop during the course of a hematologic disorder; it only precedes the disorder in 35% of cases.
Granulocytic sarcoma lesions are composed of immature myeloid elements and therefore represents focal accumulation of leukaemic cells. In contrast to its associated entities, the lesion(s) take the form of a solid soft tissue mass(es).
Being extramedullary is a key feature.
Almost any tissue can be affected, with skin and bone being the commonest. They have been reported in the skull, face, orbit and paranasal sinuses. Lesions have been reported in the tonsils, oral and nasal cavities and within the lacrimal, thyroid and salivary glands. The central nervous system can also be affected.
Exact imaging features will depend on the location and involved organ.
- CNS manifestations of granulocytic sarcoma
- spinal manifestations of granulocytic sarcoma - see article: spinal leukaemia
- head and neck manifestations of granulocytic sarcoma
- skeletal manifestations of granulocytic sarcoma
- abdomimal manifestations of granulocytic sarcoma
- thoracic manifestation of granulocytic sarcoma
History and etymology
- first described by A Burns in 1811 3
- termed "chloroma" in 1853 by King due to typical forms have a green color from high levels of myeloperoxidase in immature cells; renamed after because at least 30% of cells didn't contain myeloperoxidase.
- renamed as granulocytic sarcoma in1966 by Rappaport due later findings that not all of the cells are green
- 1. Guermazi A, Feger C, Rousselot P et-al. Granulocytic sarcoma (chloroma): imaging findings in adults and children. AJR Am J Roentgenol. 2002;178 (2): 319-25. AJR Am J Roentgenol (citation) - Pubmed citation
- 2. Lee B, Fatterpekar GM, Kim W et-al. Granulocytic sarcoma of the temporal bone. AJNR Am J Neuroradiol. 2002;23 (9): 1497-9. AJNR Am J Neuroradiol (citation) - Pubmed citation
- 3. Burns A. Observations of Surgical Anatomy: Head and Neck. Edinburgh: Thomas Royce and Company;1811 :364 –366
- 4. Seok JH, Park J, Kim SK et-al. Granulocytic sarcoma of the spine: MRI and clinical review. AJR Am J Roentgenol. 2010;194 (2): 485-9. doi:10.2214/AJR.09.3086 - Pubmed citation
- 5. Ooi GC, Chim CS, Khong PL et-al. Radiologic manifestations of granulocytic sarcoma in adult leukemia. AJR Am J Roentgenol. 2001;176 (6): 1427-31. AJR Am J Roentgenol (citation) - Pubmed citation
- 6. Turner RM, Peck WW, Prietto C. MR of soft tissue chloroma in a patient presenting with left public and hip pain. J Comput Assist Tomogr. 15 (4): 700-2. - Pubmed citation
- 7. Nikolic B, Feigenbaum F, Abbara S et-al. CT changes of an intracranial granulocytic sarcoma on short-term follow-up. AJR Am J Roentgenol. 2003;180 (1): 78-80. AJR Am J Roentgenol (citation) - Pubmed citation
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