Chloromas - acute myeloid leukemia

Discussion:

Rare case of first presentation AML, with granulocytic sarcoma (chloromas). 

Chloromas are solid extramedullary tumors, most often found in conjunction with bone or nervous tissue. The term chloroma arising from the frequent, but not exclusive, green color of the tissue on gross pathology.

Granulocytic sarcoma lesions are composed of immature myeloid elements and therefore represents focal accumulation of leukemic cells.  Various sites have been documented, with the extra-dural space being one of the commonest.  The diffuse form often involves the spinal nerve roots.

The patient's WCC turned out to be > 200 mm 3.

A bone marrow biopsy confirmed acute myeloid leukemia.

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