Quinn Thomas, Jain Manish, Lee Ming-Te
Department of Neurology, Leeds Teaching Hospitals Trust, Leeds, UK.
Department of Haematology, Leeds Teaching Hospitals Trust, Leeds, UK.
Oxf Med Case Reports. 2020 Sep 22;2020(9):omaa075. doi: 10.1093/omcr/omaa075. eCollection 2020 Sep.
Acute Promyelocytic Leukaemia (APML) is a subtype of Acute Myeloid Leukaemia (AML), responsible for around 10% of cases of the disease in adults. Extra medullary disease (EMD) occurs infrequently in APML, but where EMD does occur, the central nervous system is one of the most commonly infiltrated sites. Our case describes a man in his 40s undergoing post-therapy surveillance for APML who presented to follow-up clinic with a headache, which was ultimately found to be caused by a tumour comprised of APML cells. His case presented a diagnostic challenge due to the benign appearances of the lesion on initial computed tomography brain imaging and the non-diagnostic cerebrospinal fluid analysis. The diagnostic difficulties described in our case emphasizes that clinicians working with APML patients must approach new neurological symptoms with a high degree of suspicion to prevent diagnostic delay.
急性早幼粒细胞白血病（APML）是急性髓系白血病（AML）的一种亚型，约占成人该疾病病例的10%。髓外疾病（EMD）在APML中很少见，但一旦发生EMD，中枢神经系统是最常被浸润的部位之一。我们的病例描述了一名40多岁的男性，他正在接受APML治疗后的监测，因头痛到随访门诊就诊，最终发现头痛是由一个由APML细胞组成的肿瘤引起的。由于最初的脑部计算机断层扫描成像上病变外观良性，且脑脊液分析无诊断价值，他的病例带来了诊断挑战。我们病例中描述的诊断困难强调，治疗APML患者的临床医生必须对新出现的神经系统症状高度怀疑，以防止诊断延误。
