Clinical and imaging features of myeloid sarcoma: a German multicenter study

BMC Cancer

卷:19

Stefan Andreas Schmidt¹  Dominik Schramm²  Susanne Wienbeck³  Hans-Jonas Meyer⁴  Alexey Surov⁴  Friederike Braulke⁵  Wolfram Pönisch⁶ 

[1] Department of Diagnostic and Interventional Radiology, Ulm University Medical Center;

[2] Department of Diagnostic and Interventional Radiology, University Hospital of Halle (Saale);

[3] Department of Diagnostic and Interventional Radiology, University Medicine Göttingen;

[4] Department of Diagnostic and Interventional Radiology, University of Leipzig, University Hospital Leipzig;

[5] Department of Hematology and Medical Oncology, University Medicine Göttingen;

[6] Department of Hematology and Oncology, University Hospital Leipzig;

关键词: Myeloid sarcoma;    Granulocytic sarcoma;    Chloroma;    Acute myeloid leukemia;   

DOI  :  10.1186/s12885-019-6357-y

来源: DOAJ

【 摘 要 】

Abstract Background Myeloid sarcoma (MS), also known as chloroma, is an extramedullary manifestation of malignant primitive myeloid cells. Previously, only small studies investigated clinical and imaging features of MS. The purpose of this study was to elucidate clinical and imaging features of MS based upon a multicenter patient sample. Methods Patient records of radiological databases of 4 German university hospitals were retrospectively screened for MS in the time period 01/2001 and 06/2019. Overall, 151 cases/76 females (50.3%) with a mean age of 55.5 ± 15.1 years and 183 histopathological confirmation or clinically suspicious lesions of MS were included into this study. The underlying hematological disease, localizations, and clinical symptoms as well as imaging features on CT and MRI were investigated. Results In 15 patients (9.9% of all 151 cases) the manifestation of MS preceded the systemic hematological disease. In 43 cases (28.4%), first presentation of MS occurred simultaneously with the initial diagnosis of leukemia, and 92 (60.9%) patients presented MS after the initial diagnosis. In 37 patients (24.5%), the diagnosis was made incidentally by imaging. Clinically, cutaneous lesions were detected in 35 of 151 cases (23.2%). Other leading symptoms were pain (n = 28/151, 18.5%), neurological deficit (n = 27/151, 17.9%), swelling (n = 14/151, 9.3%) and dysfunction of the affected organ (n = 10/151, 6.0%). Most commonly, skin was affected (n = 30/151, 16.6%), followed by bone (n = 29/151, 16.0%) and lymphatic tissue (n = 21/151, 11.4%). Other localizations were rare. On CT, most lesions were homogenous. On T2-weighted imaging, most of the lesions were hyperintense. On T1-weighted images, MS was hypointense in n = 22/54 (40.7%) and isointense in n = 30/54 (55.6%). A diffusion restriction was identified in most cases with a mean ADC value of 0.76 ± 0.19 × 10− 3 mm2/s. Conclusions The present study shows clinical and imaging features of MS based upon a large patient sample in a multicenter design. MS occurs in most cases meta-chronous to the hematological disease and most commonly affects the cutis. One fourth of cases were identified incidentally on imaging, which needs awareness of the radiologists for possible diagnosis of MS.

【 授权许可】

Unknown