Abstract
Myeloid Sarcoma1 (also termed as chloroma, granulocytic sarcoma, extra medullary myeloid tumor) is a rare extra medullary tumor composed of immature myeloid cells (myeloblast)2. It is usually associated with leukemia or other myeloproliferative disorder. Myeloid Sarcoma in the central nervous system, around the brain stem is the commonest site of presentation and require high suspicion for diagnosis. We report a forty years male patient with history of dysphagia, dysphonia for last two months. MRI showed chloromas around the brain stem. Laboratory investigations revealed the presence of AML. This is a rare case of Myeloid Sarcoma around the brain stem in a patient of AML. DOI: http://dx.doi.org/10.3329/bjms.v13i4.16056 Bangladesh Journal of Medical Science Vol.13(4) 2014 p.481-483
Highlights
A forty year male presented on 15/11/2012 with dif-The condition known as chloroma was first ficulty in swallowing for semisolids and solids described by the British physician A
Because up to 30% of these tumors can be white, gray, or brown rather than green, the more correct term granulocytic sarcoma was proposed by Rappaport in 19676 and has since become virtually synonymous with the term chloroma.We report a rare case of Myeloid Sarcoma around the brain stem presenting as bulbar palsy
CNS examination showed absence of gag reflex and weakness grade 4 in right upper limb of lower motor neurone type.Investigations revealed Hb – 8.9%, ESR- 140 mm in first hour, TLC – 60, 500/cmm,DLC- P4,L6,E2,B0 Nucleated RBC – 30% Blast cells – 58% Platelet – 0.19 lac/cmm.HAEMOGRAM was suggestive of acute myeloblastic leukemia.MP – Negative, Widal – Negative, Dengue – Negative, HIV – Negative .Bone Marrow Examination – Acute Myeloid Leukemia.MRI – Chloromas around brain stem
Summary
The condition known as chloroma was first ficulty in swallowing for semisolids and solids described by the British physician A. Burns in 18113, the term chloroma did not appear until 18534. This name is derived from the Greek word chloros (green), as these tumors often have a green tint due to the presence of myeloperoxidase. Because up to 30% of these tumors can be white, gray, or brown rather than green, the more correct term granulocytic sarcoma was proposed by Rappaport in 19676 and has since become virtually synonymous with the term chloroma.We report a rare case of Myeloid Sarcoma around the brain stem presenting as bulbar palsy. 1. Kiran Kumar Singal, Associate Professor, Department of Medicine , M.M.I.M.S.R., Mullana(Ambala) India. 2. Ajay Mittal, Professor, Department of Medicine, M.M.I.M.S.R., Mullana(Ambala) India. 4. Saurav Aggarwal, Resident, Department of Medicine, M.M.I.M.S.R., Mullana(Ambala) India. 5. Rao Farman Khan, Resident, Department of Medicine, M.M.I.M.S.R., Mullana(Ambala) India. 6. Saakshi Sarin, Resident, Department of Medicine, M.M.I.M.S.R., Mullana(Ambala) India
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