Hosting 720 files, 2924 images, and 4 contributors.

Random Case

Traumatic Pseudomeningocele
Joseph Junewick, MD FACR
over 7 years ago
Enter A Workflow
Standard2   Academic2

Please choose a workflow. A standard workflow allows you to browse the repository with full case detail; the academic workflow allows you to browse the repository with limited case detail revealed. Double click on the images to launch image viewer.

ARSt Case Repository

Case History

Teenager with back pain and lower extremity paresthesias worsening over several weeks.

Case Detail

Anatomy: Brain-Spine
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: MR
Adobe32 PDF Imagej32 ImageJA

Case Images

Academic Case Revealer (Click to Expand)

Reveal Findings

MR – Mid-sagittal T1 and IR and midsagittal and parasagittal post gadolinium T1 images of the lumbosacral spine demonstrate extraosseous presacral and sacral hitatus masses. Also note the massive mesenteric lymph nodes with follicular masses.

Reveal Discussion

Granulocytic sarcoma, also known as chloroma or extramedullary myeloblastoma, is a rare solid tumor related to acute myeloid leukemia composed of primitive precursors of the granulocytic series of WBC that include myeloblasts, promyelocytes, and myelocytes. Granulocytic sarcomas of the bone commonly involve vertebral bodies, the sternum, orbits, cranium, sacrum, and ribs. Granulocytic sarcoma arises in bone marrow and traverses the haversian canals to reach the periosteum, resulting in bone lysis and sometimes adjacent soft-tissue masses and periostitis. The radiographic differential diagnoses are metastatic neuroblastoma, Ewing’s sarcoma, eosinophilic granuloma, and primitive neuroectodermal tumor in children. Lesions are isointense to bone marrow on both T1- and T2- weighted MR images; they enhance homogeneously after injection of contrast medium. Massive nodal enlargement in AML is seen in about 25% of cases and is often related to a monocytic predominance of the leukemia.

Reveal Diagnosis

Acute Myeloid Leukemia – Granulocytic Sarcoma

Corporate Office: 616.363.7272, 3264 North Evergreen Drive, Grand Rapids, MI 49525

Spectrum Health Helen Devos Childrens Hospital GE HealthCare