Granulocytic sarcoma in childhood leukemia: imaging features.

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Abstract
To assess imaging features of granulocytic sarcoma (GS) in children with myelogenous leukemia. Retrospectively analyzed were radiographs, bone scintigrams, ultrasound (US) scans, computed tomography (CT) scans, and magnetic resonance (MR) images obtained in 30 patients with acute and one with chronic myelogenous leukemia. With one exception in which GS antedated leukemia, GS was present concurrently with onset of leukemia or during remission or relapse. Radiographs, nuclear studies, and US findings were nonspecific. One parascapular GS was hyperintense on T2-weighted MR images, but in all eight central nervous system studies, tumors were isointense to gray matter, muscle, or marrow on T1-weighted images and to white matter or muscle, marrow, or both on T2-weighted images. Contrast enhancement of GS was homogenous on cranial CT scans and all MR studies. CT and MR imaging features may allow distinction of GS from hematomas and abscesses, which are also complications of leukemia. Thus, biopsy may be avoided in some patients.

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