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Granulocytic Sarcoma of Bowel: CT Findings¹

¹ From the Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2 Dong, Songpa-gu, Seoul 138-736, Korea (E.K.C., H.K.H., S.H.P., K.W.K., S.S.L.); the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (S.J.L.); and the Department of Radiology, St Mary's Hospital, College of Medicine, Catholic University of Korea, Seoul (S.E.J.). Received April 28, 2006; revision requested June 23; revision received June 28; accepted July 21; final version accepted September 18. Address correspondence to H.K.H. (e-mail: hkha{at}amc.seoul.kr).

Purpose: To evaluate retrospectively the computed tomographic (CT) findings of granulocytic sarcoma of the bowel.

Materials and Methods: The institutional review boards of all participating institutions approved this study and waived the requirement for informed consent. CT scans were retrospectively reviewed in eight patients (seven men, one woman; age range, 23–71 years; mean age, 46 years) with pathologically proved granulocytic sarcoma of the small and/or large bowel. CT findings were evaluated with regard to the sites, morphologic characteristics, and contrast material enhancement patterns of the lesions, along with other ancillary findings (ie, peritoneal and mesenteric infiltration, ascites, lymphadenopathy, bowel perforation, and obstruction).

Results: Eight patients had a total of 13 lesions in the bowel (of which eight were pathologically proved), involving the duodenum (n = 1), jejunum (n = 2), ileum (n = 5), sigmoid colon (n = 1), and rectum (n = 4); multifocal bowel lesions were noted in four patients. The lesion varied in shape, with wall thickening alone in three of 13 lesions, an intraluminal polypoid mass in four, an exophytic mass in one, and a combination of findings in five. Contrast material enhancement, relative to the back musculature, showed isoattenuation in seven lesions, hyperattenuation in four, and hypoattenuation in two. Five of eight patients had multiple peritoneal masses with diffuse mesenteric or peritoneal infiltration. Ascites was present in six of eight patients; lymphadenopathy (especially in the mesentery), in five; bowel perforation, in two; and bowel obstruction, in one.

Conclusion: Granulocytic sarcoma of the bowel is characterized by variability in shape and contrast enhancement and has a high predilection for mesenteric and peritoneal spread.

© RSNA, 2007

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