| Diffuse leukoencephalopathy and brain edema: unusual presentations of CNS relapse of acute myeloid leukemia. | |
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MedLine Citation:
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PMID: 18826442 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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An isolated CNS relapse is rarely seen in acute myeloid leukemia. However, it has a potentially fatal clinical outcome. We herein present the case of a 39-year-old man, who presented to our emergency room with horizontal diplopic images, vertigo, bilateral deafness, and progressing somnolence. Cerebral imaging revealed cerebral and cerebellar edema and a diffuse leukoencephalopathy. With the one-year-old history of an initially successfully treated FAB-M0 acute myeloid leukemia (AML) in mind, a lumbar puncture was carried out that showed a vast number of myeloid blasts in the morphologic analysis of the cerebrospinal fluid. In conjunction with normal findings in the peripheral blood-count with differential and the bone marrow examination a diagnosis of an isolated CNS relapse of the AML was made. Cytarabine chemotherapy was initiated and the symptoms resolved rapidly. To our surprise, cerebral imaging in the course of the treatment not only showed a resolution of the brain edema but also of the leukoencephalopathy, pointing to a direct infiltration of brain parenchyma by leukemic blasts. The case highlights the relevance of the CNS as a pharmacologic "sanctuary" for tumor cells in patients that on prior treatments have not received intrathecal chemotherapy or chemotherapeutics that cross the blood-brain barrier. |
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Authors:
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Michael Schumann; Philipp Kiewe; Sissel Hartlieb; Martin Neumann; Andreas Schilling; Hans-Christian Koch; Eckhard Thiel; Agnieszka Korfel |
Publication Detail:
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Type: Case Reports; Journal Article Date: 2009-09-27 |
Journal Detail:
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Title: Journal of neuroimaging : official journal of the American Society of Neuroimaging Volume: 20 ISSN: 1552-6569 ISO Abbreviation: J Neuroimaging Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-05-21 Completed Date: 2010-09-29 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9102705 Medline TA: J Neuroimaging Country: United States |
Other Details:
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Languages: eng Pagination: 198-200 Citation Subset: IM |
Affiliation:
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Department of Gastroenterology, Campus Benjamin Franklin, Charité, Berlin, Germany. michael.schumann@charite.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Brain Edema / diagnosis*, etiology* Humans Leukemia, Myeloid, Acute / complications*, diagnosis* Leukoencephalopathies / diagnosis*, etiology* Magnetic Resonance Imaging* Male Recurrence |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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