Brown L M, Daeschner C, Timms J, Crow W
Department of Neurology, University of Texas Medical Branch, Galveston 77550.
Pediatr Neurol. 1989 May-Jun;5(3):173-8. doi: 10.1016/0887-8994(89)90067-2.
A 12-year-old boy with acute myelogenous leukemia developed acute weakness and paresthesias of the lower extremities after lumbar puncture. Computed tomography and magnetic resonance imaging revealed 2 large paraspinal masses (granulocytic sarcoma) causing spinal cord compression. Treatment with corticosteroids, radiation therapy, and chemotherapy caused complete resolution of symptoms; there was no evidence of tumor on subsequent magnetic resonance imaging or at autopsy. Granulocytic sarcomas (chloromas) rarely involve the nervous system in patients with acute myelogenous leukemia, although with increased survival it is apparent that the incidence may be greater than previously believed. Central nervous system prophylaxis was not administered to our patient but may be recommended for future patients if systemic disease can be controlled. General features of central nervous system complications of acute myelogenous leukemia, characteristics of granulocytic sarcoma, and review of current radiographic techniques used in the evaluation of these tumors are discussed.
一名12岁的急性髓性白血病男孩在腰椎穿刺后出现下肢急性无力和感觉异常。计算机断层扫描和磁共振成像显示2个巨大的椎旁肿块（粒细胞肉瘤）导致脊髓受压。皮质类固醇、放射治疗和化疗使症状完全缓解；后续磁共振成像或尸检均未发现肿瘤迹象。粒细胞肉瘤（绿色瘤）在急性髓性白血病患者中很少累及神经系统，尽管随着生存率的提高，显然其发病率可能高于先前的认识。我们的患者未接受中枢神经系统预防治疗，但如果全身疾病能够得到控制，未来的患者可能会推荐进行此项治疗。本文讨论了急性髓性白血病中枢神经系统并发症的一般特征、粒细胞肉瘤的特点以及当前用于评估这些肿瘤的影像学技术综述。
