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British Journal of Radiology (2007) 80, e109-e112
© 2007 British Institute of Radiology
doi: 10.1259/bjr/16630393
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Intracranial myeloid sarcoma: conventional and advanced MRI findings

B Hakyemez, MD 1 N Yildirim, MD 1 O Taskapilioglu, MD 2 C Erdogan, MD 1 S Aker, MD 3 S Yilmazlar, MD 4 and M Parlak, Prof 1

Uludag University School of Medicine, Departments of 1 Radiology, 2 Neurology, 3 Pathology and 4 Neurosurgery, Bursa, Tukey


Figure 1
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  		Figure 1. 54-year-old male with acute myelogenous leukaemia. A lesion in the right temporo-occipital region appears isointense with brain parenchyma on (a) T1 weighted images, while it is (b) isointense/hypointense on T2 weighted images, (c, d) with slight surrounding oedema and homogeneous contrast enhancement after gadolinium injection. (e) Another lesion bordering the anterior interhemispheric fissure is seen. Both the lesions are extracranial and dural based.

 

Figure 2
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  		Figure 2. With(a) trace diffusion-weighted images, the lesion appears slightly more hyperintense than the brain parenchyma, while it is (b) markedly hypointense in apparent diffusion coefficient (ADC) images. The ADC value of the lesion is 0.49 x 10–3 mm2 s–1. The MR spectrum shows no N-acetyl aspartate (NAA, 2.02 ppm) peak, but (c) a prominent increase in the choline peak (Cho, 3.22 ppm). (d) Cerebral blood volume (CBV) images show that most parts of the lesion have lower intensity than the brain parenchyma without prominent enhancement. There is a slight enhancement around the lesion. The relative celebral blood volume ratio of the lesion is approximately 1.58.

 

Figure 3
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  		Figure 3. (a) Oval-shaped, diffusely scattered malignant lymphoid cells with hyperchromatic nuclei and (b) normal glial tissues in the left upper corner. (c) Immunohistochemical stains shows staining of tumour cells with myeloperoxidase.

 




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