Multimodal Diagnostic Approach in Cardiac Myeloid Sarcomas

Myeloid sarcomas are rare extramedullary infiltrations of immature myeloid cells seen in leukemic, myeloproliferative, and myelodysplastic syndromes. Cardiac infiltration of these cells clinically manifest based on the heart anatomy that is affected.

A 61-year-old male with significant history of acute myeloid leukemia status post hematopoietic stem cell transplant, left renal myeloid sarcoma status post chemoradiation, and left eye myeloid sarcoma status post chemoradiation was found to have new cardiac myeloid sarcomas (CMS) after presenting with subacute chest pain and new onset of atrioventricular nodal disease on electrocardiogram.

While obtaining an endomyocardial biopsy is the gold standard for diagnosing CMS, multiple diagnostic modalities can be used to determine the presence of them.

While CMS is rare, it is important to follow through with a multimodal diagnostic approach to clarify the diagnosis in the at-risk malignant hematological population when presenting with new or changing cardiac clinical presentations.