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Figure 1. Granulocytic sarcoma in a 50-year-old woman mimicking a parametrial haemorrhagic abscess. (a) Contrast-enhanced CT shows a densely enhanced, bulky mass in the right parametrium (white arrow). Focal obliteration of the fat layer between the right posterior urinary bladder and the uterus is demonstrated (black arrow), and there is no visualization of the opacified right distal ureter. Axial T1 weighted (b) and T2 weighted (c) images show a large, infiltrating mass in the uterine cervix and right parametrium. Globular enlargement of the uterine cervix and the poorly defined, haemorrhagic portions in the right parametrium (short arrow in b) are demonstrated. Thickening of the right side of the posterior urinary bladder and obliteration of the retrovesical fat are also noted (long arrow in b and arrows in c). (d) Axial contrast-enhanced T1 weighted image with a fat suppression technique demonstrates a densely enhancing uterine cervix and a poorly marginated, thick, irregular peripheral enhancing mass in the right parametrium that contains central non-enhancing portions mimicking an abscess (long arrows). The mass is infiltrated into the right side of the posterior urinary bladder (short arrow), the retrovesical fat and the visceral pelvic fascia. (e) Photomicrograph (haematoxylin/eosin stain, original magnification x 400) shows diffuse infiltrate of leukaemic blasts. (f) On the follow-up contrast-enhanced CT after anti-leukaemic chemotherapy, the parametrial mass shows a markedly decreased size and enhancement (long arrow). Note the normal configuration of the right side of the posterior urinary bladder and the preserved retrovesical fat (short arrow).
