[Vertebral granulocytic sarcoma--a rare differential diagnosis of vertebral deformity].
METHODS
The authors report on an 83-year-old woman who presented with back pain with sudden onset 6 weeks prior to admission. A radiograph of the lumbar spine revealed a vertebral deformity. An MRI (magnetic resonance imaging) scan showed bone marrow edema of the affected vertebra. Blood counts on laboratory tests were normal at the time of admission. Due to continuing pain vertebroplasty was performed, and bone biopsies were taken during the procedure. The biopsies showed infiltration of the marrow space with granulocytic sarcoma (chloroma), a tumor, which may precede the onset of acute myelogenous leukemia.


CONCLUSIONS
This case underlines the need for a thorough diagnostic work-up in patients with ongoing complaints of an assumed osteoporotic vertebral fracture. Granulocytic sarcoma represents a rare differential diagnosis of vertebral deformity.
Klinik für Radiologie und Nuklearmedizin, St. Elisabeth-Krankenhaus Köln-Hohenlind, Köln, Germany. mjergas@mac.com
Michael
M
Jergas
Sebastian
S
Eidt
Jan
J
Lammertink
D000369:Aged, 80 and over; D001416:Back Pain / Q000209:etiology*; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D005598:Fractures, Spontaneous / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000473:pathology; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009361:Neoplasm Invasiveness / Q000473:pathology; D010024:Osteoporosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D023981:Sarcoma, Myeloid / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D054854:Vertebroplasty