ASHNR '98'

uhrad.com - Case #7

Clinical History: A 14 year old male with headache and diplopia.

Granulocytic Sarcoma (Chloroma)

Findings: The noncontrast enhanced T1 images reveal replacement of the normal fatty marrow signal in the left lateral orbital wall and within the sphenoid bone on the left. The contrast enhanced axial images show that this same area enhances following contrast injection. There is minimal periosteal elevation and involvement without cortical destruction.

Discussion: Granulocytic sarcoma or chloroma is an accumulation of immature granulocytes in soft tissue or bone without systemic leukemia. Commonly, chloromas occur in the skin and lymph nodes. Bony involvement is most common in the orbit, sacrum, spine and ribs. 75% of patients are younger than 10 years. Almost all progress to systemic leukemia within two years.

Differential diagnosis includes neuroblastoma, Ewing’s tumor, rhabdomyosarcoma and osteosarcoma.

Reference:
Cho. Mandibular Chloroma. Head and Neck . Nov.1990;12:507-511.

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