CTICasesFungating Soft Tissue Chloroma with Lung Nodules/Infiltration
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Imaging findings
Lung windows show ill-defined nodules, ground glass opacities, and a large mass-like consolidation within the lungs. The key finding, however, is a huge fungating soft tissue mass arising from the patient's back, evident on prone imaging. Progression of the skin lesion from an erythematous lesion to pigmented areas, horny plaques, and finally a confluent, fungating, and crusting soft tissue mass is shown in photographs.
Key takeaways
This patient with a history of myelodysplastic syndrome that converted to AML presented with a rapidly growing, painful, fungating soft tissue mass on the back. Biopsy confirmed it to be a chloroma, an extramedullary manifestation of leukemia. The associated lung nodules and ground glass opacities are presumed leukemic infiltration. This is a dramatic and unusual presentation of a chloroma, which fortunately responded to chemotherapy.
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