Hepatic myeloid sarcoma
Citation, DOI & article data
Hepatic myeloid sarcomas, also referred to as hepatic granulocytic sarcoma or hepatic chloromas, are rare neoplasms comprised of myeloid precursor cells happening in the liver. They are a unique presentation of acute myeloid leukemia (AML).
Please refer to the main article on myeloid sarcoma/chloroma for a broad discussion on this entity.
More common locations for myeloid sarcoma are bones, lymph nodes, soft tissues, skin and breasts, with the liver involved less commonly (4% in one study) 2.
May present during remission or relapse of the underlying disease (occurs during remission in 20%) 2.
Consists of myeloid blasts or precursor cells. It sometimes stains green with the application of myeloperoxidase, hence the older term "chloroma" ("chloros" is the Greek word for "green").
Imaging features mimic hepatic lymphoma. A presumptive diagnosis of hepatic myeloid sarcoma is made in the setting of a patient with known AML.
CT and MRI
- more ill-defined margins than hepatic lymphoma
- more heterogeneous enhancement than hepatic lymphoma
- may result in biliary obstruction
- FDG-PET: highly sensitive for detection
Treatment and prognosis
Myeloid sarcoma is predictive of a poor outcome for a patient's AML.
Hepatic myeloid sarcoma is treated with chemotherapy or targeted radiotherapy 3.
- 1. Tomasian A, Sandrasegaran K, Elsayes KM et-al. Hematologic malignancies of the liver: spectrum of disease. Radiographics. 2015;35 (1): 71-86. doi:10.1148/rg.351130008 - Pubmed citation
- 2. Shinagare AB, Krajewski KM, Hornick JL et-al. MRI for evaluation of myeloid sarcoma in adults: a single-institution 10-year experience. AJR Am J Roentgenol. 2012;199 (6): 1193-8. doi:10.2214/AJR.12.9057 - Pubmed citation
- 3. Yilmaz AF, Saydam G, Sahin F et-al. Granulocytic sarcoma: a systematic review. Am J Blood Res. 2014;3 (4): 265-70. Free text at pubmed - Pubmed citation