CTICasesExtramedullary Leukemia (Myeloid Sarcoma/Chloroma) with Thymic and Paraspinal Infiltration
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Imaging findings
Initial chest radiograph demonstrated a subtle convex mediastinal lung interface, particularly in the left upper lobe (representing thymic enlargement), and an opacity overlying the aortic arch. CT imaging confirmed marked thymic enlargement and paraspinal opacities, localized within the extrapleural fat adjacent to the thoracic spine. These findings showed rapid and complete resolution following anti-leukemic therapy.
Key takeaways
Extramedullary leukemia, also known as myeloid sarcoma or chloroma, can manifest as diffuse thymic infiltration and paraspinal leukemic cell deposits, especially at the time of acute myeloid leukemia diagnosis. These lesions are typically highly responsive to systemic anti-leukemic treatment, with certain chromosomal translocations (e.g., t(9;11)) potentially associated with a higher incidence of such presentations.
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