Ultrasound Findings in a Case of Myeloid Sarcoma of the Breast

Abstract

Myeloid sarcoma is a rare, solid extramedullary tumor originating from immature granulocytic cells or monocytes. Breast involvement without an aleukemic or myeloproliferative disorder is very infrequent. A 21-year-old female patient was admitted with bilateral palpable breast masses for four months. The patient had given birth approximately one year ago. The ultrasonographic examination revealed multiple, oval shaped—some of them with microlubulated margins—hypoechoic, solid masses of which, the largest mass measured 4.5 × 2.5 cm, evaluated as BI-RADS 4. The histopthological examination suggested hematolymphoid neoplasm. In the differential diagnosis of solid breast lesions, myeloid sarcoma should be kept in mind even without hematological findings. Early diagnosis of this tumor is important for the effectiveness of the medical treatment.

Sonographic Features of a Myeloid Sarcoma of the Breast as a Relapse of Acute Myeloid Leukemia After Stem-Cell Transplantation: A Case Report

“…Although data on the same is limited, breast hamartomas are usually less elastic (Italian elastosonographic score of 3 or 4) than the tissues that surround them, and their appearance largely depends on the amount of fibrous tissue [37]. Interestingly, through our own re-evaluation of the sonographic images obtained from previous case reports, we observed, not infrequently, similar hamartoma-like patterns of the internal echotexture in breast myeloid sarcoma [2,12,13,16,22,26].…”

“…Of all breast leukemias, acute myelogenous leukemia is the most commonly occurring and it presents as myeloid sarcoma [11]. Myeloid sarcoma is an extramedullary hematological malignant tumor of myeloid cells showing varying degrees of maturation, and is most commonly observed in patients with previously diagnosed myeloid leukemia [3,12]. According to the World Health Organization, myeloid sarcomas can be classified into 3 categories: blastic (composed mainly of myeloblasts), immature (composed of myeloblast and promyelocytes), and differentiated (composed of promyelocytes and more mature neutrophils) [13].…”

“…The existing knowledge on the radiologic features of breast leukemia was obtained from sporadic case reports [18], and these features tended to vary across individual cases [12]. While a few recent articles attempted to define the representative radiologic features of intramammary hematologic malignancies [18,19], the radiologic features were non-specific, reflecting a broad spectrum of hematologic malignancies encompassing lymphoma, leukemia, and plasmacytoma [19] or both myeloid and lymphoid leukemia [18] as a whole.…”

“…Some reports clearly specified a hamartoma-like appearance when describing the sonographic features [2,16]. Furthermore, across a vast number of reports, the internal echotextures of breast myeloid sarcoma were found to be at least heterogeneous [2–4,12–16,20–24,26,27,30,35,36].…”

Breast Recurrence of Acute Myeloid Leukemia After Bone Marrow Transplantation: A Case Report About Myeloid Sarcoma of the Breast

“…Although MS is an extramedullary hematological malignancy, in which myeloid cells show various degrees of maturation, it is frequently seen in patients with previously diagnosed myeloid leukemia (9,10). According to the World Health Organization, MS is diagnosed based on three classes: blastic (consisting of myeloblasts), immature (consisting of myeloblasts and promyelocytes), and differentiated (consisting of promyelocytes and more mature neutrophils) (8).…”