Lesions of the central nervous system in leukemia: Pathological and magnetic resonance imaging features at presentation in 14 patients

Liu,Jing; Wang,Yaming; Sun,Xuefei; Liu,Shuo; Yu,Zhenkun; Ji,Nan; Sun,Shengjun; Liu,Yuanbo

doi:10.3892/ol.2017.7192

Lesions of the central nervous system in leukemia: Pathological and magnetic resonance imaging features at presentation in 14 patients

Authors:
- Jing Liu
- Yaming Wang
- Xuefei Sun
- Shuo Liu
- Zhenkun Yu
- Nan Ji
- Shengjun Sun
- Yuanbo Liu
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Affiliations: Department of Hematology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China, Department of Neurosurgery, Navy General Hospital, Beijing 100048, P.R. China, Duke Clinical Research Institute, Duke University, Durham, NC 27705, USA, Department of Otorhinolaryngology, Head and Neck Surgery, Nanjing Tongren Hospital, Southeast University, Nanjing 211100, P.R. China, Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China, Neuroimaging Center, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, P.R. China
Published online on: October 16, 2017 https://doi.org/10.3892/ol.2017.7192
Pages: 8162-8170

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Abstract

The present study aimed to characterize the specific pathology and magnetic resonance imaging (MRI) findings observed in patients with leukemia with central nervous system (CNS) lesions, and to determine their value in the management of such patients. Lesions of the CNS were observed during and following treatment of leukemia. The data from stereotactic biopsy‑proven pathology (12 patients) and MRI examinations (14 patients) were retrospectively evaluated. Proton‑magnetic resonance‑spectroscopy was performed in three patients. Factors that predisposed to lesions of the CNS were reviewed from the patient medical records. Among the 14 patients, eight had CNS leukemia, four had a CNS infection and two had a neurodegenerative disorder (one leukoencephalopathy and one glial cell hyperplasia). The clinical diagnosis based on clinical symptoms, signs and MRI features was not consistent with the pathological diagnosis in two patients. In one patient, the clinical diagnosis was a CNS infection; however, the patient's pathological diagnosis was CNS leukemia. In the other patient, the clinical diagnosis was CNS leukemia, but the pathological diagnosis was glial cell hyperplasia. CNS lesions in leukemia have a wide range of causes. Apart from the relapse of leukemia in the CNS, there are treatment‑associated neurotoxicities and infections that are caused by immunocompromised states. As numerous leukemia‑associated CNS lesions are treatable, early diagnosis is essential.

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