Cranio-cerebral abnormalities in acute leukemia: current and particular CT and MRI aspects

Congress:

ECR 2012

Poster Number:

C-2548

Type:

Educational Exhibit

Keywords:

Neuroradiology brain, Haematologic, Oncology, CT, MR, Education, Treatment effects, Radiation therapy / Oncology, Haematologic diseases, Leukaemia

Authors:

I. G. Lupescu, I. C. Lupescu, A. E. Ghergus, A. C. Nicolae, G. Popa; BUCHAREST/RO

DOI:

10.1594/ecr2012/C-2548

DOI-Link:

https://dx.doi.org/10.1594/ecr2012/C-2548

Fig. 1: Extraparenchymal bilateral masses with hemorrhagic components located in the...

Fig. 2: LEPTOMENINGEAL LEUKEMIC INFILTRATION in a clinical context of ALL-intracranial...

Fig. 3: LEUKEMIC MENINGITIS in child diagnosed with AML and progressive headache:...

Fig. 4: LEUKEMIC INFILTRATIONS of the CRANIAL NERVES in a context of Known ALL an...

Learning objectives

- To review cranio-cerebral imaging features encountered in patients with acute leukemia (AL) in correlation with the clinical issues. - To delineate the importance of neuroimaging techniques for the diagnosis and patient outcome.

Background

INTRODUCTION.Leukemias are a heterogeneous group of hematologic malignancies resulting from a neoplastic proliferation of hematopoietic cells at an undifferentiated or partially differentiated stage of maturation. Patients with acute leukemias (AL), have an increased risk of developing disease of the central nervous system (CNS) or head and neck. The WHO classification of the AL incorporates morphologic, immunophenotypic, genetic, and clinical features in an attempt to classify these entities. The AL are classified as myeloid or lymphoid on the lineage of the blast cells [1]. INCIDENCE. The...

Imaging findings OR Procedure details

PATIENTS Retrospective study along 6 years including 61 patients aged 1 to 62years (mean age:21 years) diagnosed with AL (ALL-65% of cases and AML-35% of cases) and acute or progressiveneurological signswere evaluated in our imaging department by CT and/or by MRI. The pediatric group was affected mostly by ALL in 82% of cases and the adult group preponderently by AML in 95 % of cases. TECHNIQUES Computed tomography (CT).Nonenhanced and/or enhanced CT head (1ml/kg of non ionic iodinated contrast material) protocol were done according to...

Conclusion

-Many pathologic conditions can involve the cranio-cerebral region in AL patients. These pathologic entities are related to the primary disease or to the the various antileukemic therapies (radiation therapy, chemotherapy, and bone marrow transplantation). - Knowledge of the cranio-cerebral findings in AL is essential for proper diagnosis in correlation with the clinico-biological status. - MRI is the method of choice to diagnosis (Fig. 35) and survey cranio-cerebral abnormalities in AL patients, essential for correct therapy and for increased overall survival.

Personal Information

Ass Pr.Dr.Ioana G.Lupescu Head of the Radiology and Imaging Department Fundeni Clinical Institute, Bucharest, Romania mail: [email protected]

References

Jaffe ES, Harris LN et al. Pathology and genetics tumors of haematopoiectic and lymphoid tissues. VHO, 2001, 75-106. Linet MS. Devesa 55. Descriptive epidemiology of the leukemias. In: Henderson HS, Lister TA, eds. Leukemia, 5th ed. Philadelphia: Saunders, 1990:207-224. Vincent PC. Pathophysiology. In: Henderson HS. Lister TA, eds. Leukemia, 5th ed. Philadelphia: Saunders, 1990:19-34. Chen C.Y, Zimmerman R.A, Faro S, et al. Childhood Leukemia: Central Nervous System Abnormalities during and after Treatment. AJNR , 1996, 17:295–310. Ginsberg E, Leeds N.E. Neuroradiology of Leukemia, AJR 1995;165:525-534....