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Leukemia, Spine
Lubdha M. Shah, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), granulocytic sarcoma (GS), chloroma, myeloid sarcoma (MS)
            • Definitions

              • Acute or chronic myeloid or lymphoid white blood cell neoplasia with spinal involvement as component of systemic disease

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Gross Pathologic & Surgical Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Roy AC et al: Rare case of precursor B-cell acute lymphoblastic leukemia presenting as a solitary paraspinal mass alone. J Clin Oncol. 31(22):e383-5, 2013
                                            2. Alos N et al: High incidence of vertebral fractures in children with acute lymphoblastic leukemia 12 months after the initiation of therapy. J Clin Oncol. 30(22):2760-7, 2012
                                            3. Zha Y et al: Dynamic contrast enhanced magnetic resonance imaging of diffuse spinal bone marrow infiltration in patients with hematological malignancies. Korean J Radiol. 11(2):187-94, 2010
                                            4. Chamberlain MC et al: Diagnostic tools for neoplastic meningitis: detecting disease, identifying patient risk, and determining benefit of treatment. Semin Oncol. 36(4 Suppl 2):S35-45, 2009
                                            5. Crofton PM: Bone and bone turnover. Endocr Dev. 15:77-100, 2009
                                            6. Olcay L et al: A patient with acute myeloblastic leukemia who presented with conus medullaris syndrome and review of the literature. J Pediatr Hematol Oncol. 31(6):440-7, 2009
                                            7. Laffan EE et al: Whole-body magnetic resonance imaging: a useful additional sequence in paediatric imaging. Pediatr Radiol. 34(6):472-80, 2004
                                            8. Chang YW et al: Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome. Pediatr Radiol. 33(11):791-3, 2003
                                            9. Beckers R et al: Acute lymphoblastic leukaemia presenting with low back pain. Eur J Paediatr Neurol. 6(5):285-7, 2002
                                            10. Vazquez E et al: Neuroimaging in pediatric leukemia and lymphoma: differential diagnosis. Radiographics. 22(6):1411-28, 2002
                                            11. Buckland ME et al: Spinal chloroma presenting with triplegia in an aleukaemic patient. Pathology. 33(3):386-9, 2001
                                            12. Carriere B et al: Vertebral fractures as initial signs for acute lymphoblastic leukemia. Pediatr Emerg Care. 17(4):258-61, 2001
                                            13. Shalaby-Rana E et al: (99m)Tc-MDP scintigraphic findings in children with leukemia: value of early and delayed whole-body imaging. J Nucl Med. 42(6):878-83, 2001
                                            14. Yavuz H et al: Transverse myelopathy: an initial presentation of acute leukemia. Pediatr Neurol. 24(5):382-4, 2001
                                            15. Lo LD et al: Are L5 fractures an indicator of metastasis? Skeletal Radiol. 29(8):454-8, 2000
                                            16. Kim HJ et al: Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging. Clin Imaging. 23(2):125-33, 1999
                                            17. Aisenberg J et al: Bone mineral density in young adult survivors of childhood cancer. J Pediatr Hematol Oncol. 20(3):241-5, 1998
                                            18. Novick SL et al: Granulocytic sarcoma (chloroma) of the sacrum: initial manifestation of leukemia. Skeletal Radiol. 27(2):112-4, 1998
                                            19. Sandhu GS et al: Granulocytic sarcoma presenting as cauda equina syndrome. Clin Neurol Neurosurg. 100(3):205-8, 1998
                                            20. Deme S et al: Granulocytic sarcoma of the spine in nonleukemic patients: report of three cases. Neurosurgery. 40(6):1283-7, 1997
                                            21. Wu CY et al: Detection of dural involvement by magnetic resonance imaging in adult patients with acute leukemias--preliminary experience. Ann Hematol. 70(5):243-9, 1995
                                            22. Heinrich SD et al: The prognostic significance of the skeletal manifestations of acute lymphoblastic leukemia of childhood. J Pediatr Orthop. 14(1):105-11, 1994
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Clinical Issues

                                                    • Diagnostic Checklist

                                                      TERMINOLOGY

                                                      • Synonyms

                                                        • Acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), granulocytic sarcoma (GS), chloroma, myeloid sarcoma (MS)
                                                      • Definitions

                                                        • Acute or chronic myeloid or lymphoid white blood cell neoplasia with spinal involvement as component of systemic disease

                                                      IMAGING

                                                      • General Features

                                                        • Radiographic Findings

                                                          • CT Findings

                                                            • MR Findings

                                                              • Nuclear Medicine Findings

                                                                • Imaging Recommendations

                                                                  DIFFERENTIAL DIAGNOSIS

                                                                    PATHOLOGY

                                                                    • General Features

                                                                      • Gross Pathologic & Surgical Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Roy AC et al: Rare case of precursor B-cell acute lymphoblastic leukemia presenting as a solitary paraspinal mass alone. J Clin Oncol. 31(22):e383-5, 2013
                                                                                      2. Alos N et al: High incidence of vertebral fractures in children with acute lymphoblastic leukemia 12 months after the initiation of therapy. J Clin Oncol. 30(22):2760-7, 2012
                                                                                      3. Zha Y et al: Dynamic contrast enhanced magnetic resonance imaging of diffuse spinal bone marrow infiltration in patients with hematological malignancies. Korean J Radiol. 11(2):187-94, 2010
                                                                                      4. Chamberlain MC et al: Diagnostic tools for neoplastic meningitis: detecting disease, identifying patient risk, and determining benefit of treatment. Semin Oncol. 36(4 Suppl 2):S35-45, 2009
                                                                                      5. Crofton PM: Bone and bone turnover. Endocr Dev. 15:77-100, 2009
                                                                                      6. Olcay L et al: A patient with acute myeloblastic leukemia who presented with conus medullaris syndrome and review of the literature. J Pediatr Hematol Oncol. 31(6):440-7, 2009
                                                                                      7. Laffan EE et al: Whole-body magnetic resonance imaging: a useful additional sequence in paediatric imaging. Pediatr Radiol. 34(6):472-80, 2004
                                                                                      8. Chang YW et al: Spinal MRI of vincristine neuropathy mimicking Guillain-Barre syndrome. Pediatr Radiol. 33(11):791-3, 2003
                                                                                      9. Beckers R et al: Acute lymphoblastic leukaemia presenting with low back pain. Eur J Paediatr Neurol. 6(5):285-7, 2002
                                                                                      10. Vazquez E et al: Neuroimaging in pediatric leukemia and lymphoma: differential diagnosis. Radiographics. 22(6):1411-28, 2002
                                                                                      11. Buckland ME et al: Spinal chloroma presenting with triplegia in an aleukaemic patient. Pathology. 33(3):386-9, 2001
                                                                                      12. Carriere B et al: Vertebral fractures as initial signs for acute lymphoblastic leukemia. Pediatr Emerg Care. 17(4):258-61, 2001
                                                                                      13. Shalaby-Rana E et al: (99m)Tc-MDP scintigraphic findings in children with leukemia: value of early and delayed whole-body imaging. J Nucl Med. 42(6):878-83, 2001
                                                                                      14. Yavuz H et al: Transverse myelopathy: an initial presentation of acute leukemia. Pediatr Neurol. 24(5):382-4, 2001
                                                                                      15. Lo LD et al: Are L5 fractures an indicator of metastasis? Skeletal Radiol. 29(8):454-8, 2000
                                                                                      16. Kim HJ et al: Spinal involvement of hematopoietic malignancies and metastasis: differentiation using MR imaging. Clin Imaging. 23(2):125-33, 1999
                                                                                      17. Aisenberg J et al: Bone mineral density in young adult survivors of childhood cancer. J Pediatr Hematol Oncol. 20(3):241-5, 1998
                                                                                      18. Novick SL et al: Granulocytic sarcoma (chloroma) of the sacrum: initial manifestation of leukemia. Skeletal Radiol. 27(2):112-4, 1998
                                                                                      19. Sandhu GS et al: Granulocytic sarcoma presenting as cauda equina syndrome. Clin Neurol Neurosurg. 100(3):205-8, 1998
                                                                                      20. Deme S et al: Granulocytic sarcoma of the spine in nonleukemic patients: report of three cases. Neurosurgery. 40(6):1283-7, 1997
                                                                                      21. Wu CY et al: Detection of dural involvement by magnetic resonance imaging in adult patients with acute leukemias--preliminary experience. Ann Hematol. 70(5):243-9, 1995
                                                                                      22. Heinrich SD et al: The prognostic significance of the skeletal manifestations of acute lymphoblastic leukemia of childhood. J Pediatr Orthop. 14(1):105-11, 1994