Granulocytic sarcoma (chloroma): CT manifestations

Nests of granulocytic tumor cells in patients who have myelogenous leukemia are termed chloromas. Eight cases of chloroma seen on CT were reviewed. Lymph nodes, subcutaneous tissues, peritoneum, pleural space, pelvis, and portal hepatis were involved. Two patients exhibited chloroma as the sole manifestation of their disease during bone marrow remission. The extracranial appearance of chloroma on CT is that of small, nonenhancing, nodular densities that resemble lymphoma. Cranial involvement is characteristically in the orbit. The central nervous system appearance is variable, however, and high attenuation masses may occur that mimic lymphoma, hematoma, and metastatic neuroblastoma. The recognition of these lesions is important, since radiation, not chemotherapy, is often the preferred treatment for localized chloroma.