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Abstract
Discussion Forum (0)
A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic tool.
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic tool.
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic tool.
Takamasa Kitaoji
Abstract
Discussion Forum (0)
A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic tool.
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
A case of neuroleukemiosis: The usefulness of nerve ultrasound as a diagnostic tool.
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
Poster No: 1329
Presenter: Takamasa Kitaoji
Institution: Kyoto Prefectural University of Medicine
Introduction: Neuroleukemiosis is a condition in which leukemic blasts infiltrate peripheral nerves. Neuroleukemiosis is considered a predictor of systemic relapse in acute myeloid leukemia (AML). Therefore, its early diagnosis is critical for patients with leukemia to receive appropriately timed treatment. Herein, the authors report a patient with AML for whom peripheral nerve ultrasound was helpful for the diagnosis of neuroleukemiosis in the tibial nerve.
Methods: Case: A 52-year-old female with AML became aware of paresthesia of the left lower limb. She had been diagnosed with M5b type AML one year prior to the onset of the symptom, and undergone remission induction and consolidation therapy. After achieving remission, she had also undergone allogenic hematopoietic stem cell transplantation 6 months prior to the neurological symptom onset. The patient was seen for neurological evaluation 4 months after onset of paresthesia. On neurological examination, the patient had paresthesia and sensory disturbance in the left sole and weakness in the left gastrocnemius muscle.
Results: Nerve conduction studies (NCS) showed a decreased compound muscle action potential amplitude and a decreased conduction velocity in the left tibial nerve. Ultrasound of the left tibial nerve showed nerve enlargement and loss of fascicular architecture with hypoechoic change inside the nerve. MRI revealed a nodule on the left tibial nerve. Cerebrospinal fluid findings and bone marrow evaluation were not suggestive of leukemia relapse. However, positron emission tomography - computed tomography using 18F-fluorodeoxyglucose and a biopsy of the left inguinal lymph node revealed an extramedullary relapse of AML. After the reinduction chemotherapy, the left tibial nerve enlargement on ultrasound showed improvement although neurological and NCS findings did not improve significantly. The nerve enlargement in this case was considered as the finding reflecting neruoleukemiosis.
Conclusions: Peripheral nerve ultrasound is useful for early recognition and the diagnosis of neuroleukemiosis in patients with AML.
References: No
References 1:
References 2:
References 3:
References 4:
Grant Support:
Keywords: neuromuscular ultrasound, neuroleukemiosis, acute myeloid leukemia
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