Spinal cord involvement in chronic lymphocytic leukemia

Getaz, E. P.; Miller, Gary J.

doi:10.1002/1097-0142(197905)43:5<1858::aid-cncr2820430539>3.0.co;2-e

Cited by 51 publications

(17 citation statements)

References 14 publications

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“…9 The predominant lesion in one case of spinal cord disease was perivascular infiltration. 8 Though cord compression is a very rare complication of CLL, it is potentially treatable and early diagnosis provides the best chance for the patient. Our patient showed surgically satisfactory improvement after surgical decompression followed by local radiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Cord compression: a rare complication of chronic lymphocytic leukaemia.

Majumdar¹,

Singh²

1992

Journal of Clinical Pathology

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Two years after the diagnosis, while the disease was under good control, a patient with chronic lymphocytic leukaemia (CLL) developed spinal cord compression from an extradural solid tumour composed of leukaemic cells. He was treated successfully with resection of the tumour followed by local radiotherapy and systemic chemotherapy.Central nervous system complications, though common in acute leukaemias and in the blastic phase of chronic granulocytic leukaemia, are extremely rare in chronic lymphocytic leukaemia (CLL).'2 We report a patient who developed acute cord compression as a result of extradural leukaemic deposit two years after CLL had been diagnosed.

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Section: Discussionmentioning

confidence: 99%

Cord compression: a rare complication of chronic lymphocytic leukaemia.

Majumdar¹,

Singh²

1992

Journal of Clinical Pathology

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“…This complication is seen more often in children -indeed the so called meningeal leukaemia stands for infiltrative lesions in all layers of the meninges and can manifest with cranial nerve palsies and raised intracranial tension [9]. Leukaemic cell proliferation in the pia-arachnoid layer may block cerebrospinal fluid circulation and produce hydrocephalus in children [10].…”

Section: Discussionmentioning

confidence: 99%

“…Postmortem TABLE1 Age distribution -leukaemia with autopsy proved eNS involvement Age group in years ALL (25) No. of cases with eNS involvement on autopsy CLL (5) AML (38) CML (14) Total ( 3 (7) 15 (25) o (1) 1 (3) o (1) 1 (5) 17 (23) 6 (12) 1 (3) 24 (38) o (1) 4 (9) 1 (4) 5 (14) 2 (5) 27 (37) 13 (29) 3 (10) o (1) 45 (82) Figures in parentheses indicate total number of cases in that group. .l\1I4FI, 51 : 3, July 1995 findings are detailed in, Table 2.…”

Section: Observationsmentioning

confidence: 99%

Leukaemic Involvement of Central Nervous System

Akhtar¹,

Kumar

et al. 1995

Medical Journal Armed Forces India

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Eighty two patients of leukaemia consisting of 25 cases of acute lymphocytic leukaemia, 38 cases of acute myeloid leukaemia, 14 cases of chronic myeloid leukaemia and 5 cases of chronic lymphocytic leukaemia were evaluated for central nervous system (eNS) involvement. Speech disorders, cranial nerve palsies, encephalopathy, ataxia, intracranial haemorrhage, peripheral neuropathy and spinal cord involvement were the main neurological findings detected in 23 (28.1%) cases. All except one were subjected to autopsy after death. Leukaemic infiltrations (36.6%) and intracranial haemorrhage (26.8%) were the prominent CNS autopsy findings. In addition, demyelination with astrocytosis (9.7%) and gliosis (2.4%) were seen. In all, 45 (54.9%) of the patients showed CNS involvement at autopsy. Thus a large number ofCNS lesions were missed clinically and detected only on autopsy. MJAFI 1995; 51 : 161-164

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“…The majority of established cases include leptomeningeal spread and spinal cord involvement. 10,12,16,17,19,22,27,28 Among sellar and parasellar metastases, CLL comprises a minute proportion. 1 In the largest retrospective study by Bower et al, 7 only 8 of 962 patients with CLL demonstrated CNS involvement.…”

Section: Chronic Lymphocytic Leukemia Infiltration Of the Pituitary Gmentioning

confidence: 99%

Combined chronic lymphocytic leukemia and prolactinoma: a rare occurrence in a patient presenting with pituitary apoplexy

Krisht

Palmer

Couldwell

2013

JNS

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Pituitary involvement in B-cell CLL and pituitary apoplexy, independently, are 2 rare events. Their co-occurrence in addition to the presence of prolactin-secreting adenoma cells, however, has never been described in the literature. We present the case of a combined pituitary CLL and prolactinoma apoplexy in a 77-year-old man to highlight the importance of imaging the brain in patients with CLL who present with signs and symptoms of pituitary apoplexy. To the best of our knowledge, there are only 2 other reported cases of CLL manifesting as a pituitary mass lesion.11,21 The current case is the first instance of a combined pituitary CLL-prolactinoma presenting with pituitary apoplexy. This case illustrates the need to carefully evaluate pituitary tumor specimens from patients with CLL for small lymphocytic infiltration, notwithstanding the presence of pituitary adenoma cells. Case ReportHistory and Examination. This 77-year-old man with untreated CLL diagnosed 8 years earlier presented with a 2-day history of severe bifrontal headaches associated with nausea and vomiting, including left facial numbness and complete ophthalmoplegia of his left eye. Three weeks prior to his admission he was hospitalized at an outside hospital for a pulmonary embolus and discharged on a regimen of 5 mg of oral warfarin at bedtime along with subcutaneous injections of 115 mg of enoxaparin every 12 hours as a bridging therapy. At his initial examination at our institution, he was awake, alert, and fully oriented. Positive findings included complete dense ophthalmoplegia of the left eye, diminished facial sensation to all sensory modalities along the V1 and V2 distributions, and right eye blindness secondary to glaucoma. Visual acuity remained Combined chronic lymphocytic leukemia and prolactinoma: a rare occurrence in a patient presenting with pituitary apoplexy The authors describe a rare case of combined pituitary chronic lymphocytic leukemia (CLL) and prolactinoma in a 77-year-old man presenting with apoplexy. This case highlights the importance of evaluating the pituitary gland in patients with CLL who present with clinical manifestations of apoplexy as well as the need to carefully evaluate pathological specimens from the gland for the presence of lymphocytic cells in those patients. This is the first reported case of a combined CLL-prolactinoma pituitary lesion presenting with apoplexy.

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Spinal cord involvement in chronic lymphocytic leukemia

Abstract: A patient with typical chronic lymphocytic leukemia (CLL) who developed central nervous system involvement is presented. The CLL was of B-cell origin and the neurological involvement consisted of perivascular infiltration in the spinal cord.

Cited by 51 publications

References 14 publications

Cord compression: a rare complication of chronic lymphocytic leukaemia.

Cord compression: a rare complication of chronic lymphocytic leukaemia.

Leukaemic Involvement of Central Nervous System

Combined chronic lymphocytic leukemia and prolactinoma: a rare occurrence in a patient presenting with pituitary apoplexy

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