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Atypical MRI findings in treatment-related leukoencephalopathy: case report

  • Diagnostic Neuroradiology
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Abstract

A patient with acute myeloblastic leukaemia showed atypical findings on MRI following combination therapy including intrathecal methotrexate and radiation. MRI findings not previously been reported are ring as well as patchy enhancement, marked mass effect and lesions extending to the putamen and corpus callosum.

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References

  1. Thompson BCB, Sanders JE, Flournoy N, Buckner CD (1986) The risks of central nervous system relapse and leukoencephalopathy in patinets receiving marrow transplants for acute leukemia. Blood 67:195–199

    Google Scholar 

  2. Biti GP, Magrini SM, Villari N, Caramella D (1988) Brain damage after treatment for acute lymphoblastic leukemia. Acta Oncol 28:253–256

    Google Scholar 

  3. Kay HEM, Knapton PJ, O'Sullivan JP, Wells DG (1972) Encephalopathy in acute leukemia associated with methotrexate therapy. Arch Dis Child 47: 344–354

    Google Scholar 

  4. Norrell N, Wilson CB, Slagel DE, Clark DB (1974) Leukoencephalopathy following the administration of methotrexate into the cerebrospinal fluid in the treatment of primary brain tumors. Cancer 33:923–932

    Google Scholar 

  5. Rubinstein LJ, Herman MM, Long TF, Wilbur JR (1975) Disseminated necrotizing leukoencephalopathy: a complication of treated central nervous system leukemia and lymphoma. Cancer 35: 291–305

    Google Scholar 

  6. Shibutani M, Okada R, Hori A, Schipper H (1989) Methotrexate-related multifocal axonopathy. Acta Neuropathol 79:333–335

    Google Scholar 

  7. Glass JP, Lee YY, Bruner J, Field WS (1986) Treatment-related leukoencephalopathy. Medicine 65:154–162

    Google Scholar 

  8. Skullerud K, Halvorsen K (1978) Encephalopathy following intrathecal methotrexate treatment in a child with acute leukemia. Cancer 42:1211–1215

    Google Scholar 

  9. Liu HM, Maurer HS, Vongsvivut S, Conway JJ (1978) Methotrexate encephalopathy. Hum Pathol 9:635–648

    Google Scholar 

  10. Winick BNJ, Smith SD, Shuster J, Lauer S (1993) Treatment of CNS relapse in children with acute lymphoblastic leukemia: a pediatric oncology group study. J Clin Oncol 11:271–278

    Google Scholar 

  11. Bleyer WA (1981) Neurologic sequelae of methotrexate and ionizing radiation: a new classification. Cancer Treat Rep 65:89–98

    Google Scholar 

  12. Asato R, Akiyama Y, Ito M, Kubota M (1992) Nuclear magnetic resonance abnormalities of the cerebral white matter in children with acute lymphoblastic leukemia and malignant lymphoma during and after central nervous system prophylactic treatment with intrathecal methotrexate. Cancer 70:1997–2004

    Google Scholar 

  13. Mohrmann RL, Mah V, Vinters HV (1989) Neuropathologic findings after marrow transplantation. Hum Pathol 21:630–639

    Google Scholar 

  14. Hwang T-L, Yung WKA, Estey EH, Fields WS (1985) Central nervous system toxicity with high-dose Ara-C. Neurology 35:1475–1479

    Google Scholar 

  15. Breuer AC, Pitman SW, Dawson DM (1977) Paraparesis following intrathecal cytosine arabinoside. Cancer 40:2817–2822

    Google Scholar 

  16. Vinters HV, Anders KH (1987) Focal pontine leukoencephalopathy in immunosuppressed patients. Arch Pathol Lab Med 111:192–196

    Google Scholar 

  17. Johnson FL, Thomas ED, Clark BS, Chard RL (1981) A comparison of marrow transplantation with chemotherapy for children with acute lymphoblastic leukemia in second or subsequent remission. N Engl Med 301:846

    Google Scholar 

  18. Price RA, Jamieson PA (1975) The central nervous system in childhood leukemia. II. Subacute leukoencephalopathy. Cancer 35:306–318

    Google Scholar 

  19. Bleyer WA (1977) Current status of intrathecal chemotherapy in human meningeal neoplasms. Natl Cancer Inst Monogr 46:171–176

    Google Scholar 

  20. Allen JC, Rosen G, Mehta M, Harlen B (1980) Leukoencephalopathy following high-dose IV methotrexate chemotherapy with leukovorin rescue. Cancer Treat Rep 64 1261–1273

    Google Scholar 

  21. Ito M, Akiyama Y, Asato R, Kubota M (1991) Early diagnosis of leukoencephalopathy of acute lymphocytic leukemia by MRI. Pediatr Neurol 7:436–439

    Google Scholar 

  22. Miyatake S, Kikuchi H, Oda, Y, Ishikawa M (1992) A case of treatmentrelated leukoencephalopathy: sequential MRI, CT and PET findings. J Neurooncol 14:143–149

    Google Scholar 

  23. Ebner F, Ranner G, Slave I, Urban C (1989) MR findings in methotrexate-induced CNS abnormalities. AJNR 10: 959–964

    Google Scholar 

  24. Weingarten KL, Zimmerman RD, Leeds NE (1983) Spontaneous regression of intracerebral lymphoma. Radiology 149:721–724

    Google Scholar 

  25. McKinstry CS, Worthington BS, Lewis PD, Lowe J (1986) Primary intracranial lymphoma. Acta Radiol [Suppl] (Stockh) 369:147–149

    Google Scholar 

  26. Brant-Zawadzki M, Berry I, Osaki L, Brasch R (1986) Gd-DTPA in clinical MR of the brain. 1. Intraaxial lesions. AJNR 7:781–788

    Google Scholar 

  27. Hochberg FH, Miller DC (1988) Primary central nervous system lymphoma. J Neurosurg 68:835–853

    Google Scholar 

  28. Dooms GC, Hecht S, Brant-Zawadzki M, Berthiaume Y (1986) Brain radition lesions: MR imaging. Radiology 158: 149–155

    Google Scholar 

  29. Valk PE, Dillon WP (1991) Radiation injury of the brain. AJNR 12:45–62

    Google Scholar 

  30. Oppenheimer JH, Levy ML, Sinha U, El-Kadi H (1992) Radionecrosis secondary to interstitial brachytherapy: correlation of magnetic resonance imaging and histopathology. Neurosurgery 31:336–343

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan

    Y. Ohmoto, K. Kajiwara, S. Kato, T. Nisizaki & H. Ito

  2. First Department of Pathology, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan

    S. Tamura

Authors
  1. Y. Ohmoto
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  2. K. Kajiwara
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  3. S. Kato
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  4. T. Nisizaki
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  5. H. Ito
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  6. S. Tamura
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Ohmoto, Y., Kajiwara, K., Kato, S. et al. Atypical MRI findings in treatment-related leukoencephalopathy: case report. Neuroradiology 38, 128–133 (1996). https://doi.org/10.1007/BF00604796

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  • DOI: https://doi.org/10.1007/BF00604796

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