Imaging Findings and Misdiagnosis Analysis of Intracranial Granulocytic Sarcoma

YU Yan-hong; CHEN Wei-jun; WANG Ning; NIU Yan-kun; JIN Long-po; GUO Cheng-wei

doi:10.3969/j.issn.1002-3429.2014.08.019

Abstract：Objective To improve the understanding of intracranial granulocytic sarcoma( GS) and reduce misdiagno-sis by evaluating the CT and MRI findings. Methods The CT and MRI findings and other clinical data of 9 patients with GS proved by clinical features or pathology were retrospectively analyzed. Results CT and MRI imaging showed parenchymal in-filtration with hemorrhage in 4 cases, intracranial tumors with bone destruction in 3 cases, and 2 cases were showed meningeal involvement. Among of 9 cases, only 2 cases were diagnosed as GS initially. However, 7 cases were misdiagnosed:hyperten-sive intracerebral hemorrhage in 2 cases, metastases in 2 cases;brain tumors, skull base chondrosarcoma and intracranial hy-potension syndrome in one each. Through bone marrow aspiration cytology, 4 cases were diagnosed as acute lymphoblastic leu-kemia, 3 cases were diagnosed as acute myeloid leukemia, and 2 cases were diagnosed with chronic myelomonocytic leukemia. 3 cases of them were diagnosed as leukemia at first and confirmed as GS finally. Because of initial neurological symptoms and typical GS cells by examination of cerebrospinal fluid, 6 cases were diagnosed as GS correctively. After appro-priate treatment, 8 cases were cured and 1 case died. Conclusion Intracranial GS may mainly perform as parenchymal infil-tration ( hematoma) , intracranial tumor formation associated with bone destruction and meningeal involvement with obstructive hydrocephalus. Combined CT and MRI may be helpful for diagnosis and can provide valuable assistance to early treatment and prognostic evaluation.