Department of Internal Medicine, Hematology, Oncology and Immunology, University Hospital Marburg und Giessen, Marburg, Hessen, Germany.
Gastroenterology and Interdisciplinary Center of Ultrasound, Department of Internal Medicine, University Hospital Marburg and Giessen, Marburg, Hessen, Germany.
Ultrasound Med Biol. 2022 Sep;48(9):1933-1940. doi: 10.1016/j.ultrasmedbio.2022.05.024. Epub 2022 Jun 28.
Chloromas, also referred to as myeloid sarcomas, describe rare extramedullary tumor aggregates of malignant myeloid progenitor cells. The aim of this study was investigate the diagnostic features and characteristics of chloromas using contrast-enhanced ultrasound (CEUS). Between July 2007 and April 2021, 15 patients with 20 myeloid neoplasms and suspected chloroma manifestations were examined using B-mode US (B-US) and CEUS. Clinical data and B-US (echogenicity, border, size) and CEUS (hyper-, iso-, hypo- or complex enhancement) characteristics were retrospectively analyzed. Absolute and relative frequencies were determined. In B-US, the chloromas were most frequently hypo-echoic (n = 15, 75%). In addition, a hyperechoic (n = 2, 10%) or echocomplex (n = 3, 15%) presentation was observed. On CEUS, 7 chloromas (35%) had an arterial hyperenhancement, 8 (40%) an iso-enhancement and 3 (15%) a complex enhancement. Two chloromas (10%) did not exhibit any enhancement. We describe for the first time CEUS and B-US patterns of chloromas. They are typically hypo-echoic on B-US and have a strong iso- or hyperenhancement on CEUS, which may help in the differential diagnosis of some unclear masses (e.g., hematoma, abscess) in patients with myeloid neoplasias. Nevertheless, histology is necessary for a reliable diagnosis.
绿色瘤又称髓肉瘤，是指恶性髓系前体细胞在骨髓外形成的罕见肿瘤聚集。本研究旨在通过对比增强超声（CEUS）研究绿色瘤的诊断特征和特点。在 2007 年 7 月至 2021 年 4 月期间，对 15 例 20 例髓系肿瘤且疑似有绿色瘤表现的患者进行了 B 型超声（B-US）和 CEUS 检查。回顾性分析了临床资料及 B-US（回声强度、边界、大小）和 CEUS（高、等、低或混合增强）特征。确定了绝对和相对频率。在 B-US 中，绿色瘤最常表现为低回声（n=15，75%）。此外，还观察到高回声（n=2，10%）或回声复杂（n=3，15%）表现。在 CEUS 上，有 7 个绿色瘤（35%）表现为动脉期增强，8 个（40%）为等增强，3 个（15%）为混合增强。有 2 个绿色瘤（10%）没有增强。我们首次描述了绿色瘤的 CEUS 和 B-US 模式。它们在 B-US 上通常为低回声，在 CEUS 上呈强烈的等或高增强，这可能有助于鉴别髓系肿瘤患者一些不明确肿块（如血肿、脓肿）的诊断。然而，组织学检查对于可靠的诊断是必要的。
