Department of Anesthesiology and Pain Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Anesthesiol. 2021 Feb;74(1):65-69. doi: 10.4097/kja.20128. Epub 2020 Jun 5.
Neuroleukemiosis is a rare complication of leukemia. The diagnosis may be delayed owing to non-specific symptoms and the need for special diagnostic modalities.
A 70-year-old man in his sixth year of remission from acute myeloid leukemia was referred to the pain clinic for shooting and radiating pain in the left posterior leg. A lumbar spine magnetic resonance imaging showed mild disc bulging of the L2-3, which was insufficient to explain the patient's symptoms. With insufficient pain response to lumbar epidural block and piriformis injection, we examined both sciatic nerves using an ultrasound and identified an enlarged hypoechoic mass on the left sciatic nerve at mid-thigh level. After that, we biopsied the mass under general anesthesia, and histology confirmed it to be neuroleukemiosis.
Ultrasound is an inexpensive, non-invasive, simple, and quick diagnostic modality that can be used as a screening tool in the diagnosis of neuroleukemiosis.
神经白血病是白血病的一种罕见并发症。由于非特异性症状和需要特殊诊断方式，诊断可能会被延误。
一名 70 岁男性，在急性髓细胞白血病缓解的第六年，因左腿后侧的枪击样和放射性疼痛被转诊到疼痛诊所。腰椎磁共振成像显示 L2-3 椎间盘轻度膨出，但不足以解释患者的症状。腰椎硬膜外阻滞和梨状肌注射对疼痛的反应不足，我们使用超声检查了两条坐骨神经，并在大腿中段的左侧坐骨神经上发现一个扩大的低回声肿块。之后，我们在全身麻醉下对肿块进行了活检，组织学证实为神经白血病。
超声是一种廉价、无创、简单、快速的诊断方式，可作为神经白血病诊断的筛查工具。
