Granulocytic Sarcoma in the Head and Neck: CT and MR Imaging Findings

OBJECTIVES: To evaluate characteristic computed tomography (CT) and magnetic resonance (MR) imaging findings of granulocytic sarcomas of the head and neck. METHODS: The CT (n=11) and MR (n=1) images obtained from 11 patients (7 males and 4 females; mean age, 23.5 yr; age range, 1 to 69 yr) with histologically-proven granulocytic sarcomas of the head and neck were retrospectively reviewed. Histological confirmation was done by bone marrow biopsy in 9 patients, and/or local biopsy in 4 patients. The imaging findings were analyzed with particular attention to location, size, shape, margin, bone destruction, internal architecture, pattern and degree of enhancement, and multiplicity of the lesions. RESULTS: The masses were most commonly located in the orbital cavity (n=8); other locations included lymph nodes (n=5) and palatine/pharyngeal/lingual tonsils (n=3). The mass sizes varied from a mean diameter of 1.3 to 5.8 cm (average, 2.6 cm). Multiple lesions were found in 6 patients. The shapes of the tumors were ovoid in 12 patients and irregular in 4 patients. Most lesions had poorly-defined margins (13/16) and invaded adjacent bony structures (5/16). On the pre-contrast CT images, the masses were iso- (5/8) or low-density (3/8) in comparison with muscle. The MRI, which was obtained in one patient in this study, showed that the mass was iso-signal intensity on T1-weighted images and iso-signal intensity on T2-weighted images compared to the gray matter of the brain. On the post-contrast CT images, there was homogenesous (n=12) or heterogeneous (n=4) enhancement, with mild (n=10), moderate (n=4), and marked (n=2) enhancement in the solid portions of the lesions. CONCLUSION: Although rare, granulocytic sarcomas arise in various locations in the head and neck area (most commonly in the orbit) in the form of well-demarcated, and mildly- and homogenously-enhancing masses with adjacent bony invasion.

MR Images of Primary Localized Amyloidosis of the Ureter and Bladder: A Case Report

Primary localized amyloidosis of the ureter and bladder is a very rare condition. CT and cystoscopic findings are indistinguishable from malignant neoplasm or inflammatory lesions. We report a case of unilateral distal ureteral thickening caused by primary localized amyloidosis. MR image features of hypointensity on T2-weighted images and mural enhancing pattern on contrast enhanced T1-weighted images can be helpful for diagnosis of ureteral amyloidosis.

Traumatic Diaphragmatic Hernia with a Delayed Presentation: A Report on Two Cases of Omental Herniation that Simulated Pleural Effusion

Traumatic diaphragmatic hernia may show a delayed presentation and it rarely simulates pleural effusion. We report here on two asymptomatic cases that were diagnosed by performing chest CT.