Presentation of Gallbladder Chloroma in B-Mode Imaging and Contrast-Enhanced Ultrasound (CEUS) in a Patient with Acute Myelomonocytic Leukemia (AML M5)

 

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Introduction

Chloromas (myeloid sarcoma) are solid tumors consisting of primitive myeloid precursors and have been described in acute myeloid leukemia (AML) and myeloproliferative disorders (Aznab, Mozaffar; Kamalian, Naser; Beiki, Omid et al., Int J Hematol Oncol Stem Cell Res 2015; 9 (1), S. 50–54). In AML, they are observed in 3-8% of all cases, while the frequency varies (J. C.; Edenfield, W. J.; Shields, D. J. et al., Extramedullary myeloid cell tumors in acute nonlymphocytic leukemia: a clinical review. In: J Clin Oncol 1995, 13 (7), S. 1800–1816). Chloromas can be observed at diagnosis, precede the diagnosis, occur during the course of the disease or manifest as a relapse of the AML (Aznab, Mozaffar; Kamalian, Naser; Beiki, Omid et al., Int J Hematol Oncol Stem Cell Res 2015; 9 (1), S. 50–54). They can affect every organ system, with infiltration of bone, skin, soft tissues and lymph nodes being observed most frequently (Aznab, Mozaffar; Kamalian, Naser; Beiki, Omid et al., Int J Hematol Oncol Stem Cell Res 2015; 9 (1), S. 50–54), J. C.; Edenfield, W. J.; Shields, D. J. et al., Extramedullary myeloid cell tumors in acute nonlymphocytic leukemia: a clinical review. In: J Clin Oncol 1995, 13 (7), S. 1800–1816). Single case reports describe chloromas of the gallbladder and the bile ducts (Azin, Arash; Racz, Jennifer M.; Carolina Jimenez, M. et al. Int J Surg Case Rep 2014;5 (6), S. 302–305). In summary, we present the first description of contrast-enhanced ultrasound (CEUS) patterns of a histologically confirmed gallbladder chloroma.