Chloroma of the adrenal gland and the peritoneum: CT diagnosis of an unusual presentation of acute myeloid leukemia

Abstract

Chloroma (syn: granulocytic sarcoma) is an unusual solid extramedullary manifestation of acute myeloid leukemia (AML) consisting of deposits of myeloid precursor cells. Most chloromas develop during the course of leukemia or following. In rare cases, they are the first and sole manifestation of AML. In this specific condition, the diagnosis of chloroma can, therefore, be difficult to differentiate from lymphoma or other malignancies using clinical, radiological and even histopathological methods. Chloromas can involve any part of the body, however, bone, periosteum, soft tissue, lymph nodes and skin are the most common sites. Imaging appearance of chloromas is not specific but the diagnosis should be strongly considered in patients with a history of leukaemia who develop a solid tumor. This report describes the CT appearance of an unusual case of chloroma in a 70-year-old man presenting with a suprarenal mass and multiple peritoneal involvements, but no haematological abnormalities.