Isome Ken-ichi, Matsubara Kousaku, Taki Tomohiko, Nigami Hiroyuki, Yura Kazuo, Iwata Aya, Wada Tamaki, Taniwaki Masafumi, Fukaya Takashi
Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan.
J Pediatr Hematol Oncol. 2011 Mar;33(2):153-7. doi: 10.1097/MPH.0b013e3181e005b2.
Spinal cord compression is a rare complication of acute lymphoblastic leukemia (ALL). We report a 13-year-old boy with B-precursor ALL, presenting with restriction of breathing and back pain. Cerebrospinal fluid examination showed extremely high protein levels. Radiologic examination indicated that leukemia extended from the thoracic to sacral epidural spaces over 21 vertebral lengths in a band-shaped form, threatening to induce compressive spinal cord neuropathy. Prompt initiation of systemic chemotherapy relieved the obstruction of cerebrospinal fluid flow without local irradiation or surgical intervention. To our knowledge, this patient has shown the most extensive epidural involvement among ALL patients previously reported.
脊髓压迫是急性淋巴细胞白血病（ALL）的一种罕见并发症。我们报告一名13岁的B前体ALL男孩，表现为呼吸受限和背痛。脑脊液检查显示蛋白水平极高。放射学检查表明白血病以带状形式从胸椎延伸至骶椎硬膜外间隙，跨越21个椎体长度，有诱发压迫性脊髓神经病变的风险。及时开始全身化疗缓解了脑脊液流动梗阻，无需局部放疗或手术干预。据我们所知，该患者是先前报道的ALL患者中硬膜外受累最广泛的。
