Chloroma as a Presenting Feature of Acute Leukemia

Abstract

Chloroma is an unusual presenting feature of acute leukemia in childhood. From the Greek chloros, meaning green, the term refers to localized discolored masses of leukemic tissue; these are most commonly found in relation to the periosteum of the skull, paranasal sinuses, orbits, vertebrae or ribs. Since Allen Burns'¹ original description in 1821, numerous authors have reported additional cases. Huber² in 1878 first described the accompanying changes in the blood, but apparently did not appreciate the significance of the association. The association with leukemia was first suspected by von Recklinghausen³ in 1855, but remained to be established by Dock and Warthin⁴ in 1904. At first the association was thought to be of lymphoid origin, but subsequent studies showed the cells in most cases to be myelogenous.^5,6 Examples with monocytic leukemia, probably of the "Naegeli type" and thus of myelogenous origin have also been described.^7,8