Singh Anuradha, Kumar Pawan, Chandrashekhara Sheragaru Hanumanthappa, Kumar Atin
Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.
Br J Radiol. 2017 Jul;90(1075):20160710. doi: 10.1259/bjr.20160710. Epub 2017 May 23.
Chloroma refers to the extramedullary proliferation of immature myeloid precursors occurring in a gamut of myeloproliferative and myelodysplastic conditions; acute myeloid leukaemia being the commonest. With non-specific clinical and imaging manifestations, it runs a high risk of misdiagnosis which may significantly affect the outcome of an otherwise treatable lesion. Also with these lesions heralding impending blast crises, awareness of the imaging findings becomes imperative. Imaging not only helps raise the suspicion but also guides further confirmation by demonstration of specific immunohistochemistry markers, ensuring timely institution of chemotherapy. In general, solid enhancing lesions in any haematological disorder could be chloromas, especially if multifocal with mass effect.
绿色瘤是指在一系列骨髓增殖性疾病和骨髓增生异常综合征中出现的未成熟髓系前体细胞的髓外增殖;急性髓系白血病是最常见的病因。由于其临床表现和影像学表现不具特异性,误诊风险很高,这可能会显著影响原本可治疗病变的预后。此外,这些病变预示着即将发生原始细胞危象,因此了解其影像学表现至关重要。影像学不仅有助于提高怀疑度,还能通过显示特定的免疫组化标志物来指导进一步确诊,确保及时进行化疗。一般来说,任何血液系统疾病中出现的实性强化病变都可能是绿色瘤,尤其是伴有占位效应的多灶性病变。