Case of the Week
Section Editors: Matylda Machnowska1 and Anvita Pauranik2
1University of Toronto, Toronto, Ontario, Canada
2BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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November 27, 2014
Granulocytic Sarcoma of the Spine
- Granulocytic sarcoma of the spine (GS), also known as chloroma, is a localized tumor formed by primitive myeloid cells at an extramedullary site.
- GS is seen in patients with acute myelogenous leukemia (2.5%–9.1% ), or it may represent a blastic phase of chronic myelogenous leukemia.
- Clinical presentation varies with location of the tumor.
- Key Diagnostic Features:
- Usually, in an appropriate clinical setting, an extra-axial iso- to hyperdense mass on noncontrast CT appearing hypointense on T2WI and enhancing homogeneously upon contrast administration, with associated diffusion restriction, should suggest the diagnosis of GS.
- Best diagnostic clue: Immunohistochemistry, including myeloperoxidase, CD 15 (granulocyte-associate antigen), and neutrophil elastase, is especially effective in differentiating GS from other tumors.
- DDx:
- Metastases
- Lymphoma
- Meningioma
- Infection
- Rx:
- Radiation therapy
- Chemotherapy
- High-dose steroids
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