Pulmonary leukemia in a child presenting with infiltrative and nodular lesions

Corbatón, J.; Muñoz, Alvaro; Madero, L; Camarero, C.

doi:10.1007/bf02343435

Pediatr Radiol

1984

DOI: 10.1007/bf02343435

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Pulmonary leukemia in a child presenting with infiltrative and nodular lesions

J. Corbatón

Alvaro Muñoz

L Madero

et al.

Abstract: A leukemic child developed a pulmonary leukemic infiltration, confirmed by open lung biopsy. His radiograph showed a mixed interstitial and nodular pattern. Nodular lung lesions are rare in pediatric patients and may exceptionally represent leukemic invasion.

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1992

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Cited by 3 publications

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“…In addition, some patients with extramedullary involvement at diagnosis such as in the CNS and/or testis require more intense treatment. Apart from these common invasion sites, extramedullary involvement (with and without symptoms) has been increasingly reported in the kidneys, pancreas, muscle tissue, lungs and prostate, probably due to the progress in imaging . Several case reports involving extramedullary site invasion have suggested very poor prognosis even with allogeneic stem cell transplantation .…”

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confidence: 99%

“…Apart from these common invasion sites, extramedullary involvement (with and without symptoms) has been increasingly reported in the kidneys, pancreas, muscle tissue, lungs and prostate, probably due to the progress in imaging. [4][5][6][7][8][9] Several case reports involving extramedullary site invasion have suggested very poor prognosis even with allogeneic stem cell transplantation. 4,5,8 This, however, is yet to be confirmed in large clinical trials.…”

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confidence: 99%

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Accurate detection of renal leukemic involvement in children using 3‐D computed tomography modeling

Fujiki

Nishimura

Mase

et al. 2019

Pediatrics International

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Background The rate of renal involvement in pediatric acute lymphoblastic leukemia (ALL) at diagnosis varies between reports because renal involvement is diagnosed on renal size larger than aged‐matched standards on conventional modalities. We propose a new method for precise renal involvement detection using 3‐D enhanced computed tomography (CT) reconstruction. Methods Twenty‐five children with ALL were evaluated utilizing 3‐D enhanced CT reconstruction to measure renal volume before and after induction therapy, renal mass lesions and renal axis at diagnosis. Renal involvement was defined as a marked decrease of renal volume or the presence of mass lesions. Results According to the 3D‐CT criteria, nine of 25 patients (36%) had renal involvement. All of them had bilateral mass lesions except for one who had diffuse nephromegaly alone. This method detected renal involvement more accurately than ultrasonography. When using conventional criteria based on the length of the renal axis, 19 of 25 (76%) had renal involvement, including many cases of false‐positive nephromegaly. Patients with renal involvement had significantly more extramedullary involvement according to the 3D‐CT‐based criteria. Conclusions The use of 3D‐CT reconstruction was accurate in detecting renal involvement in childhood ALL, most of which consisted of piled up mass lesions. Patients with renal involvement should be worked up for the detection of other extramedullary lesions.

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mentioning

confidence: 99%

mentioning

confidence: 99%

Accurate detection of renal leukemic involvement in children using 3‐D computed tomography modeling

Fujiki

Nishimura

Mase

et al. 2019

Pediatrics International

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Acute lymphoblastic leukemia a comprehensive review with emphasis on biology and therapy

Cortés

Kantarjian

1995

Cancer

118

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Background. Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. It is now curable in 60–70% of children. Most of the current understanding of the biology and treatment of ALL originates from studies of children. In adults, although much progress has been achieved, ALL is curable in only 20–35% of patients. Methods. A review of the biology and treatment of ALL from the English literature was performed. Results. Immunophenotypic and cytogenetic analyses of ALL have contributed to a more rational classification of ALL. These analyses have identified subgroups with poor prognosis or with different therapeutic requirements. Overall, 60–70% of adults with ALL have poor prognostic features, including older age, a high leukocyte count, non—T‐cell innmunophenotype, Ph‐positive genotype, and longer time to achieve a complete remission. These patients have a cure rate of 20–25% whereas those without these risk factors, have a 60–70% probability of survival. The use of more intensive induction regimens with growth factor support may improve survival rates. Also, intensive consolidation‐intensification may improve survival rates. Most patients benefit from maintenance therapy, but the dose schedule must be optimized. Central nervous system (CNS) prophylaxis is beneficial, particularly for patients with a high risk for CNS relapse and when introduced early during induction of remission. Patients with high risk characteristics may benefit from allogeneic bone marrow transplantation (BMT) during first remission, and all other patients may benefit from it during first or subsequent relapse. Autologous BMT may be a valuable option for poor compliant patients. Conclusions. Although the prognosis of patients with ALL has improved markedly during the past decades, newer strategies, including more dose‐intensive therapy, the search for new drugs, and more target‐specific therapy, are needed to improve the current cure rates.

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Bronchiolitis obliterans-organizing pneumonia (BOOP) in children with malignant disease

et al. 1992

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Four patients who had completed chemotherapy for malignant disease are presented. Unexpected findings of pulmonary infiltrates on chest radiographs of two patients and solitary and/or confluent nodules on CT in all four led to open lung biopsy. Histologic diagnosis in each case was bronchiolitis obliterans-organizing pneumonia (BOOP). This usually innocuous disorder can be differentiated histologically from the more severe pure bronchiolitis obliterans and should be considered in the differential diagnosis of pulmonary lesions associated with malignant disease.

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Pulmonary leukemia in a child presenting with infiltrative and nodular lesions

Abstract: A leukemic child developed a pulmonary leukemic infiltration, confirmed by open lung biopsy. His radiograph showed a mixed interstitial and nodular pattern. Nodular lung lesions are rare in pediatric patients and may exceptionally represent leukemic invasion.

Cited by 3 publications

References 8 publications

Accurate detection of renal leukemic involvement in children using 3‐D computed tomography modeling

Accurate detection of renal leukemic involvement in children using 3‐D computed tomography modeling

Acute lymphoblastic leukemia a comprehensive review with emphasis on biology and therapy

Bronchiolitis obliterans-organizing pneumonia (BOOP) in children with malignant disease

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