Musculoskeletal Imaging

Myeloid Sarcoma: A Primer for Radiologists

Chiu, Austin M. BA^∗; Yoon, Justin G. MD^∗; Tirumani, Sree H. MD^∗,†; Ramaiya, Nikhil H. MD^∗,†; Smith, Daniel A. MD^†

From the ^∗Case Western Reserve University School of Medicine

^†Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH.

Received for publication May 22, 2022; accepted October 9, 2022.

Correspondence to: Daniel A. Smith, MD, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106-6007 (e-mail: [email protected]).

The authors declare no conflict of interest.

All authors are responsible for the contents and have read and approved the manuscript for submission. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Journal of Computer Assisted Tomography 47(3):p 475-484, 5/6 2023. | DOI: 10.1097/RCT.0000000000001440

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.