Myeloid sarcoma of the heart: Extramedullary relapse of acute myeloblastic leukemia, presenting with complete heart block and atrial flutter after second allogeneic stem cell transplantation

Myeloid Sarcoma: A Primer for Radiologists

ABSTRACT

Myeloid sarcoma (MS) is a rare extramedullary neoplasm that can present in association with acute myeloid leukemia, most commonly in children younger than 15 years. This unique extramedullary malignancy may involve a variety of different organ systems and can present following, preceding, simultaneous with, or in insolation to acute myeloid leukemia. Common areas of extramedullary involvement include soft tissues, bones, lymph nodes, and the peritoneum. Imaging plays a critical role in the diagnosis and management of MS, with commonly used modalities including positron emission tomography-computed tomography, magnetic resonance imaging, computerized tomography, and ultrasound. The purpose of this review article is to provide radiologists with a comprehensive guide summarizing the relevant imaging and clinical features of MS, with emphasis on the role of imaging in the diagnosis, treatment, and follow-up of patients with MS. The relevant pathophysiology, epidemiology, clinical presentations, and differential diagnosis of MS will be reviewed. The relevance of different imaging modalities in diagnosis, monitoring of treatment response, and assessment of treatment-related complications will also be outlined. Through summarizing these topics, this review article aims to provide radiologists with a guide for understanding the existing knowledge of MS in the literature and the current role of imaging in the management of this unique malignancy.

18 F-FDG PET/CT Findings of Myeloid Sarcoma Involving the Left Ventricle and Kidney in a Pediatric Patient

ABSTRACT

A 1-year-old girl presented with vomiting for 1 week. Abdominal ultrasound revealed a mass with increased blood flow in the left lower abdomen. A malignancy was suspected. 18 F-FDG PET/CT showed multiple lesions in the left ventricular wall, the kidney, and the left lower abdomen. Biopsy of the left abdominal mass confirmed the diagnosis of myeloid sarcoma associated with acute myeloid leukemia. After 4 cycles of chemotherapy, follow-up PET/CT was performed for evaluating the therapy response, which showed complete resolution.