Leukemic Involvement in the Thorax

Abstract

Leukemias are malignancies in which abnormal white blood cells are produced in the bone marrow, resulting in compromise of normal bone marrow hematopoiesis and subsequent cytopenias. Leukemias are classified as myeloid or lymphoid depending on the type of abnormal cells produced and as acute or chronic according to cellular maturity. The four major types of leukemia are acute myeloid leukemia, chronic myeloid leukemia, acute lymphoblastic leukemia, and chronic lymphocytic leukemia. Clinical manifestations are due to either bone marrow suppression (anemia, thrombocytopenia, or neutropenia) or leukemic organ infiltration. Imaging manifestations of leukemia in the thorax are myriad. While lymphadenopathy is the most common manifestation of intrathoracic leukemia, leukemia may also involve the lungs, pleura, heart, and bones and soft tissues. Myeloid sarcomas occur in 5%-7% of patients with acute myeloid leukemia and represent masses of myeloid blast cells in an extramedullary location. ©

Pediatric thoracic mass lesions: Beyond the common

“…It is a rare condition with slight male predominance and may occur at any age, more commonly in infants than in older children and at any site of the body [10,31]. However, the skin, orbits, central nervous system, and paraspinous regions are the most common sites, with occasional presentations in the chest wall adjacent to the ribs and sternum [32]. Clinical presentation is dependent on tumor location, with symptoms usually occurring as a result of a tumor mass effect or local organ dysfunction [31].…”

“…Chloromas have a strong predilection for subperiosteal and perineural involvement (Fig. 4) [32]. Histopathologic inspection shows that the tumor is composed of primitive precursors of the granulocytic series that include myeloblasts, promyelocytes and myelocytes [30].…”

“…Histopathologic inspection shows that the tumor is composed of primitive precursors of the granulocytic series that include myeloblasts, promyelocytes and myelocytes [30]. Typical imaging findings are a high attenuation mass with intense contrast enhancement on CT, iso-/hypointensity on T1-weighted MRI, mild hyperintensity on T2-weighted MRI, and restricted diffusion on diffusion weighted imaging (DWI) due to the high cellularity [32]. Fluorodeoxyglucose-positron emission tomography (FDG-PET) is useful because of its ability to detect the lesions that are clinically occult or not detectable on conventional imaging.…”

Tuberculosis in posttransplant recipients: Challenges in fluorodeoxyglucose positron emission tomography/computed tomography reporting in countries with a high prevalence of tuberculosis

“…Mediastinal lymph node involvement was the common manifestation of thoracic AML. [ 11 12 ] FDG PET-CT can help in early detection of occult E-AML. It can guide biopsy from the active site.…”

Indolent Presentations of Leukemic Lung Disease in Acute Myeloid Leukemia

“…17 Three manifestations of leukemic lung disease have been defined in the literature: (i) leukostasis, an emergent medical condition characterized by intravascular accumulation of blasts, increased blood viscosity, vascular inflammation, and multi-organ dysfunction; 18–20 (ii) leukemic infiltration (LI) of blasts into the lung parenchyma; and (iii) acute tumor lysis pneumopathy (ATLP), an inflammatory lung injury precipitated by chemotherapy-induced lysis of blasts within the lung. 1,8,21,22 Leukostasis is well-described, with clearly defined diagnostic criteria that facilitate prompt recognition and treatment. 18–20 However, the clinical features of LI and ATLP in patients with AML have not been fully characterized.…”