Abstract
Leukemia may initially present as a peripheral neuropathy, leading to a delay in diagnosis. Leukemic infiltration of peripheral nerves, or neuroleukemiosis (NL), is exceedingly rare, with no established diagnostic or therapeutic guidelines. Five cases are presented. All patients were men with a median age of 68 years (range 46-72). Three patients had acute myeloid leukemia (AML) and two had chronic lymphocytic leukemia (CLL). In two patients, leukemia presented with peripheral nerve involvement and both were found to have positive cerebrospinal fluid (CSF) cytology, making the diagnosis AML, despite negative bone marrow and peripheral smear. All patients had painful, progressive, motor and sensory deficits. Clinical patterns were mononeuropathy (n =1), multiple mononeuropathies (n =1) and plexopathy (n =3). Magnetic resonance imaging (MRI) detected mass lesions in 4/5 cases, with avid fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) useful in all of these for following clinical disease progression. Three cases of nerve biopsy were performed, two of which were diagnostic of leukemic infiltration. Radiation treatment rapidly relieved pain in patients with mass lesions, in combination with chemotherapy. Four p...Continue Reading
References
Aug 1, 1992·Journal of Internal Medicine·R Billström, A Lundquist
Nov 1, 1991·Cancer·Y NishiH Nawata
Nov 1, 1988·Cancer·M J StillmanK M Foley
Mar 1, 1987·Neurology·D A KrendelD G Graham
Jan 1, 1971·Acta Neuropathologica·Y Olsson
Aug 1, 1983·International Journal of Radiation Oncology, Biology, Physics·L Y ChakR S Cox
Feb 15, 1982·Cancer·E M Mazur, J R Bertino
Jan 1, 1994·Acta Oncologica·D Roig-VilasecaA Renau
Jun 1, 1994·Archives of Neurology·A LekosS I Harik
Apr 1, 1993·Neuropathology and Applied Neurobiology·A VitalG Gbikpi-Benissan
Aug 1, 1993·Leukemia & Lymphoma·J M BoironJ Reiffers
Jan 1, 1996·Neurology·S C CramerD N Louis
Nov 15, 1995·Cancer·I MellerT Ferit
Jan 3, 2001·The New England Journal of Medicine·H DöhnerP Lichter
Jul 24, 2001·Neuroradiology·A GrahamC Smith
Apr 17, 2002·Pediatric Radiology·Anne PatersonPhilip M Rosoff
Jun 19, 2002·Blood·Sandra R WolmanUNKNOWN Southwest Oncology Group
Jun 22, 2002·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A TrojanT F Hany
Mar 22, 2003·Blood·Jacques DelaunayUNKNOWN Bordeaux-Grenoble-Marseille-Toulouse cooperative groups
Oct 21, 2003·Leukemia & Lymphoma·Jan-Peter GlossmannAndreas Josting
Aug 19, 2007·Neurology·M PlattenW Wick
Sep 14, 2007·Clinical Neurology and Neurosurgery·C P E LangeCh J Vecht
Sep 19, 2007·International Journal of Hematology·Hao-Chuan LiuTzeon-Jye Chiou
Dec 7, 2007·Cell Structure and Function·Yasuteru SanoTakashi Kanda
Jul 2, 2008·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Santosh KesariDaniel J Deangelo
Jul 8, 2008·Journal of the Peripheral Nervous System : JPNS·Michelle L MauermannP James B Dyck
Jul 22, 2008·Muscle & Nerve·Dawit G AregawiDavid Schiff
Jan 14, 2009·Neurology·Chafic KaramDaniel J MacGowan
Oct 20, 2010·Nature Reviews. Clinical Oncology·Paula Cramer, Michael Hallek
Jan 5, 2011·Advances in Hematology·Richard BakstJoachim Yahalom
Jan 12, 2011·Clinical Nuclear Medicine·Yulia BronsteinEric Rohren
Jul 20, 2011·Journal of Pediatric Hematology/oncology·Johann H HsuBetty Herrington
Feb 16, 2012·Muscle & Nerve·Jennifer A SweetAnthony J Caputy
Citations
Sep 23, 2014·Neurology India·Meena Angamuthu KannanRupam Borgohain
May 23, 2014·American Journal of Hematology·Carlos G RomoJorge E Cortes
Aug 27, 2014·Muscle & Nerve·Tingzhong WangAilin Li
Jan 1, 2016·American Journal of Hematology·Isabel Cunningham, Brigett Kohno
Jun 20, 2015·Current Pain and Headache Reports·Marcela Romero-ReyesYi Ye
May 27, 2015·Current Neurology and Neuroscience Reports·Wolfgang Grisold, Anna Grisold
Apr 30, 2015·Skeletal Radiology·Stepan CapekRobert J Spinner
Jun 22, 2016·Neurosurgery Clinics of North America·Gaddum Duemani ReddyShaan M Raza
Oct 21, 2016·Annals of Hematology·Chiara BrianiLivio Trentin
Nov 29, 2017·Der Nervenarzt·C BrandM T Pedro
Jul 28, 2017·Muscle & Nerve·Ž SnojG Bodner
Jul 24, 2020·Skeletal Radiology·Rodrigo LunaShivani Ahlawat
Jul 4, 2017·Proceedings·Rona Joseph PoikayilLali V Soman
Jul 21, 2021·Practical Neurology·Antonia S Carroll, Michael P T Lunn
Jul 27, 2021·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Robert J Spinner