| Calcified cerebral necrosis following ALL therapy. | |
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MedLine Citation:
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PMID: 6949906 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Calcified cerebral necrosis was an unusual finding at the autopsy of a 13-year-old girl who died after prolonged therapy for ALL. The patient had shown symptoms of progressive cerebral damage subsequent to a second cycle of prophylactic high-dose cytostatic therapy combined with cranial irradiation. Pathoanatomic examination revealed extensive florid recurrency of meningosis and leukemic encephalosis with scalloped calcified necroses measuring up to 5 cm, in the medullar layer of brain and cerebellum. Located predominantly near the ventricular area, encapsulated necroses showed many fibrous vessels with thickened walls and stenosed or obstructed lumina. The cerebral cortex remained largely unaffected by tissue destruction. Besides methotrexate toxicity and the enhancing effect of irradiation the vascular involvement was interpreted as a particularly important factor. Formal pathogenesis is attributed to combined chemo- and radiotherapy in parallel to leukemic infiltration of vascular walls and partial obstruction of lumina by tumor emboli. Wall damage, severe fibrosis, and consecutive nutritional defects result in the destruction of cerebral tissue. The preferential occurrence of necroses in cortex-adjacent medullar layers is explained by the relatively poor blood supply of this border zone between meningeal and intracerebral tissue, no safe conclusion can be drawn pathoanatomically with regard to the actually fatal factor, whether it is the leukemic infiltration of vascular walls, the effect of cytostatic agents, or that of irradiation. The proposed multifactorial pathogenesis of cerebral calcification may be supported by computed tomography (CT) intra vitam. |
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Authors:
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K M Müller; R Menne; K D Bachmann; H Gröbe |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of cancer research and clinical oncology Volume: 102 ISSN: 0171-5216 ISO Abbreviation: J. Cancer Res. Clin. Oncol. Publication Date: 1981 |
Date Detail:
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Created Date: 1982-05-12 Completed Date: 1982-05-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7902060 Medline TA: J Cancer Res Clin Oncol Country: GERMANY, WEST |
Other Details:
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Languages: eng Pagination: 81-91 Citation Subset: IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Brain / pathology* Calcinosis / etiology* Female Humans Leukemia, Lymphoid / complications, pathology*, therapy Methotrexate / adverse effects Necrosis Radiotherapy / adverse effects |
| Chemical | |
Reg. No./Substance:
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59-05-2/Methotrexate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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