Spinal intramedullary granulocytic sarcoma: Magnetic resonance imaging

Kook, Hoon; Hwang, Tai Ju; Kang, Heoung Keun; Kim, Soo H.; Kim, Jun H.

doi:10.1016/0730-725x(93)90421-9

Cited by 21 publications

(14 citation statements)

References 8 publications

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“…29) Other common sites are the orbits and the paranasal sinuses. 12,17) Paraspinal 12) and intraspinal 20) granulocytic sarcomas are also common. Multifocal granulocytic sarcoma is known but is relatively rare.…”

Section: Discussionmentioning

confidence: 99%

“…Granulocytic sarcoma may occur in any part of the body, such as bone, orbit, paranasal sinus, para-and intraspine, skin, stomach, colon, kidney, breast, cervix, and vagina. 3,12,16,17,19,20,31,32) Granulocytic sarcoma is generally observed as a complication of acute myeloblastic leukemia, myelodysplastic syndromes, or myeloproliferative disorders, 6,7,23) with an incidence of 3.1-4.7%. 25,30) The clinical status of granulocytic sarcoma has been classified into four groups: primary disease; granulocytic sarcoma detected at diagnosis of acute myeloblastic leukemia; isolated recurrence of acute myeloblastic leukemia, as a new isolated focus of granulocytic sarcoma that occurs during bone marrow remission and not followed by medullary relapse in less than 30 days; and granulocytic sarcoma with concurrent bone marrow relapse of acute myeloblastic leukemia.…”

Section: Introductionmentioning

confidence: 99%

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Isolated Recurrence of Granulocytic Sarcoma Manifesting as Extra- and Intracranial Masses

Nishimura

Kyuma

Kamijo

et al. 2004

Neurol. Med. Chir.(Tokyo)

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A 30-year-old female presented with a rare case of isolated recurrence of granulocytic sarcoma manifesting as extra-and intracranial masses 16 months after successful treatment of acute myeloblastic leukemia (M-2). She presented with a swelling located on her forehead that had appeared just after hitting her forehead, and never diminished in size. The mass was elastic hard and not freely mobile. Computed tomography and magnetic resonance imaging demonstrated enhanced masses in the right frontal extra-and intracranial region with no bone destruction. There was no evidence of relapse in the bone marrow. Needle aspiration biopsy of the subscalpal mass was performed. Fluorescence in situ hybridization revealed AML1/MTG8 fusion gene associated with t(8; 21). Two courses of systemic chemotherapy with high-dose cytarabine and total neural axis irradiation resulted in complete remission.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Isolated Recurrence of Granulocytic Sarcoma Manifesting as Extra- and Intracranial Masses

Nishimura

Kyuma

Kamijo

et al. 2004

Neurol. Med. Chir.(Tokyo)

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“…The role of the imaging study in the treatment of GS is to distinguish GS from hemorrhage and abscess that can occur frequently in patients with leukemia and to permit prompt initiation of appropriate therapy. For example, the MRI images of the GS tumors are isointense to brain, bone marrow or muscle on either T 1 -weighted or T 2 -weighted images and enhance homogeneously with gadopentetate dimeglumine [26,27] which help to distinguish GS from hemorrhage and abscess. In our series, 20 patients underwent imaging studies.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors of Treatment Outcomes in Patients with Granulocytic Sarcoma

Lan¹,

et al. 2009

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Purpose: To investigate the possible prognostic factors of survival outcomes in patients with granulocytic sarcoma (GS). Methods: We retrospectively investigated the prognostic factors determining survival in 24 patients with GS using Kaplan-Meier survival analysis followed by log rank tests. We evaluated gender, age, location, GS antedating leukemia, underlying disorders, treatment type and stem cell transplantation. Results: The 5-year survival rate for the patients with GS was 21%. The patients undergoing chemotherapy had a significantly longer survival time compared to those who did not (p = 0.0009). We found no difference in the 5-year survival rate among the patients undergoing chemotherapy combined with radiation or surgery. Patients with chronic myelogenous leukemia and myelodysplastic disorders had worse survival rates (p = 0.0028). Conclusion: Early diagnosis with biopsy and early chemotherapy can improve survival outcome. Local radiation or surgery can improve symptoms but does not influence survival outcomes.

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“…When MS develops in the CNS, magnetic resonance imaging is useful. 69 MS uniformly enhances with gadolinium, which should be administered when there are no contraindications ( Figure 3B). 67 The radiographic appearance of MS was recently reviewed by Fritz et al with many representative images provided.…”

Section: Which Imaging Tests Aid In the Diagnosis Of Ms And Evaluatinmentioning

confidence: 99%

How I treat extramedullary acute myeloid leukemia

Bakst¹,

Tallman

Douer

et al. 2011

Blood

418

586

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IntroductionAcute leukemia may present in a variety of extramedullary (EM) tissues with or without bone marrow disease. EM involvement by acute leukemia is a relatively rare, but clinically significant, phenomenon that often poses therapeutic dilemmas. Myeloid sarcoma (MS) and leukemia cutis (LC) represent 2 well-known EM manifestations. MS (also known as granulocytic sarcoma or chloroma) is a rare EM tumor of immature myeloid cells. It was first described in 1811 1 and later named "chloroma" by King 2 in 1853 because of its green color caused by the presence of myeloperoxidase (MPO). 3 Five decades later, the relationship of MS to acute leukemia was identified. 4 The term "granulocytic sarcoma" was introduced later by Rappaport to describe only tumors of granulocytic origin 5 ; however, the term is now often applied to any tumor related to acute leukemia or myelodysplastic syndrome (MDS).LC is the infiltration of the epidermis, dermis, or subcutis by neoplastic leukocytes (leukemia cells) resulting in clinically identifiable cutaneous lesions. LC commonly results in subcutaneous nodules and can be confusingly referred to as cutaneous granulocytic sarcoma. 6,7 For the purposes of this article, LC will refer to cutaneous involvement only. LC has been described mostly in acute myeloid leukemia (AML), but also in the accelerated phase of chronic myeloid leukemia, MDS, and rarely in acute lymphocytic leukemias. 7 In this article, we describe an approach and therapeutic strategies for patients with EM manifestations of leukemia by addressing a series of questions commonly raised by the practicing clinician. How common are MS and LC, respectively?MS is reported in 2.5%-9.1% 8-10 of patients with AML and occurs concomitantly, following, or, rarely, antedating the onset of systemic bone marrow leukemia. 11 Isolated MS, defined by the absence of a history of leukemia, MDS, or myeloproliferative neoplasm and a negative bone morrow biopsy, has been described in limited case reports. 12 Many of these patients are often misdiagnosed with lymphoma. 13,14 Certain known AML cytogenetic abnormalities, in particular t(8,21), have been associated with a higher incidence. 15 MS can also develop at relapse with or without marrow involvement. The incidence of patients developing MS after allogeneic hematopoietic cell transplantation (HCT) has been reported to be 0.2%-1.3% with poor overall survival. 16,17 LC occurs in ϳ 3% of patients with AML 18 and less frequently in chronic leukemias. 19 The reported incidence may be overestimated if biopsy is not performed because skin lesions similar to LC have a wide range of inflammatory, neoplastic, and infectious etiologies. 19 Certain subtypes of AML are more commonly associated with skin infiltration. The most frequent association occurs with acute myelomonocytic and monocytic differentiation with involvement in up to 50% of patients. 18,20,21 The incidence of LC may be higher in children, particularly infants with myeloid leukemia. 22 How do MS and LC most often present clinically?MS most...

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Spinal intramedullary granulocytic sarcoma: Magnetic resonance imaging

Cited by 21 publications

References 8 publications

Isolated Recurrence of Granulocytic Sarcoma Manifesting as Extra- and Intracranial Masses

Isolated Recurrence of Granulocytic Sarcoma Manifesting as Extra- and Intracranial Masses

Prognostic Factors of Treatment Outcomes in Patients with Granulocytic Sarcoma

How I treat extramedullary acute myeloid leukemia

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