File:Chloroma - acute myeloid leukemia (Radiopaedia 66668-75975 B 1).jpg

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Summary:

Description
  • Radiopaedia case ID: 66668
  • Image ID: 47121100
  • Plane projection: 100x
  • Aux modality: B. H & E. High power left temporal lobe tumour.
  • Study description: Pathology
  • Study findings: Micrographs A-C: Left temporal lobe tumor. Primitive-appearing blue cell neoplasm, large areas of necrosis, and fragments of brain parenchyma. Neoplastic cells have round to angulated, pleomorphic, hyperchromatic nuclei associated with scant amounts of cytoplasm and are arranged in sheets. There are numerous mitoses. C: Left temporal lobe tumor staining positively for MPO. D: Left temporal lobe tumor staining positively for CD 117. E. Sections of cancellous left temporal bone bone show deposits of primitive appearing small blue cell neoplasm in the marrow space, morphologically similar, with features of remodeling. F. Sections of skeletal (left temporalis) muscle and connective tissue show similar morphology to the myeloid sarcoma in the left temporal lobe. MPO immunohistochemistry is diffusely positive in infiltrating cells. Immunohistochemical stains:MPO: Diffusely positive.CD117: Diffuse positivity, mildly patchy.Synaptophysin: Highlights neuropil in areas of invasion.CD68: Largely negative.S100: Negative.Cytokeratin: Negative.CD20: Negative.CD3: Highlights reactive background T cells.
  • Modality: Pathology
  • System: Central Nervous System
  • Findings: 4.8 cm x 3.2 cm (axial) x 2.9 cm (craniocaudal) heterogenous mass centered in the anterior left temporal lobe. The crescentic peripheral portion of the lesion demonstrates hyperattenuation relative to the remainder of the brain parenchyma on noncontrast study and demonstrates avid enhancement on post-contrast imaging. Low attenuation centrally in the lesion consistent with necrosis. Surrounding vasogenic edema, most pronounced in the left temporal and parietal lobes with associated mass effect, with effacement of the sulcal pattern of the left temporal and parietal lobes, slight effacement of the left basal ganglia, basal cisterns, and of the left lateral ventricle; with minimal (2 mm) left-to-right midline shift. Sclerotic changes noted in the anterior left temporal bone with evidence of transosseous extension of tumor better seen on the MRI.
Date Published: 1st Mar 2019
Source https://radiopaedia.org/cases/chloroma-acute-myeloid-leukaemia
Author Danielle Byrne
Permission
(Permission-reusing-text)		 http://creativecommons.org/licenses/by-nc-sa/3.0/

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Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)

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