Irie Sayo, Inoue Akihiro, Nakamura Taisuke, Kobayashi Yusuke, Yamaguchi Tadashi, Aoki Ryo, Kamide Hiroyuki, Nishii Toshiaki, Sekikawa Zenjiro
Department of Radiology, Yokohama City University Medical Center, 4-57 Urafunecho Minami-ku, Yokohama-shi, Kanagawa-ken 232-0024, Japan.
Radiol Case Rep. 2025 Jan 28;20(4):2063-2069. doi: 10.1016/j.radcr.2025.01.035. eCollection 2025 Apr.
Myeloid sarcoma is a malignancy characterized by the excessive proliferation of immature myeloid cells or myeloblasts, leading to tumor formation outside the bone marrow. This condition often manifests before or after the onset of acute myeloid leukemia or during a relapse following initial remission. Myeloid sarcoma develops in any organs or parts of the body, but its occurrence in the mediastinum is rare. We report 2 cases of myeloid sarcoma in the mediastinum. The first case was a 63-year-old woman who experienced exertional dyspnea and was found to have a mediastinal mass along with a left pleural effusion on computed tomography (CT). Blood tests revealed abnormal cells, and a diagnosis of acute myeloid leukemia was confirmed by a bone marrow examination. A CT-guided biopsy of the mediastinal mass confirmed myeloid sarcoma. The second case was a 43-year-old man who presented with dyspnea on exertion and was discovered to have a mediastinal mass compressing the trachea and bronchus on CT. Additionally, a soft tissue lesion with bone destruction in his left maxillary sinus was found on CT. His blood tests showed no abnormalities. Since the CT-guided biopsy of the mediastinal mass did not yield a definitive diagnosis, the second biopsy of the maxillary sinus lesion led to the diagnosis of myeloid sarcoma. It is crucial to consider myeloid sarcoma in the differential diagnosis of mediastinal tumors to facilitate early detection and treatment.
髓系肉瘤是一种恶性肿瘤,其特征为未成熟髓系细胞或成髓细胞过度增殖,导致骨髓外形成肿瘤。这种情况常发生在急性髓系白血病发病之前或之后,或在初次缓解后的复发期间。髓系肉瘤可发生于身体的任何器官或部位,但发生于纵隔者罕见。我们报告2例纵隔髓系肉瘤。首例为一名63岁女性,她在活动时出现呼吸困难,计算机断层扫描(CT)检查发现纵隔肿块及左侧胸腔积液。血液检查发现异常细胞,骨髓检查确诊为急性髓系白血病。纵隔肿块的CT引导下活检确诊为髓系肉瘤。第二例为一名43岁男性,他在活动时出现呼吸困难,CT检查发现纵隔肿块压迫气管和支气管。此外,CT检查发现其左上颌窦有骨质破坏的软组织病变。他的血液检查未发现异常。由于纵隔肿块的CT引导下活检未能明确诊断,上颌窦病变的第二次活检确诊为髓系肉瘤。在纵隔肿瘤的鉴别诊断中考虑髓系肉瘤至关重要,以便于早期发现和治疗。