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Pediatric Radiology

, Volume 34, Issue 5, pp 400–408 | Cite as

Imaging findings of recurrent acute lymphoblastic leukemia in children and young adults, with emphasis on MRI

  • Rosalyn P. Porter
  • Sue C. KasteEmail author
Pictorial Essay

Abstract

Acute lymphoblastic leukemia (ALL) is the most common of all childhood malignancies. Current remission rates approach 80%. Recurrent disease can present in a wide variety of ways. MR imaging plays a crucial role in the detection of disease relapse. Because other disorders can mimic recurrence of leukemia, it is important for the radiologist to judge recurrence from non-recurrence accurately in order to avoid unnecessary testing and emotional stress on the patient and family.

Keywords

Acute lymphoblastic leukemia ALL Magnetic resonance Childhood leukemia 

References

  1. 1.
    Margolin JF, Steuber CP, Poplack DG (2001) Acute lymphoblastic leukemia. In: Pizzo PA, Poplack DG (eds) Principles and practice of pediatric oncology, 4th edn. Lippincott, Philadelphia, pp 489–544Google Scholar
  2. 2.
    Haddy TB, Mosher RB, Reaman GH (2001) Osteoporosis in survivors of acute lymphoblastic leukemia. Oncologist 6:278–285PubMedGoogle Scholar
  3. 3.
    Rivera GK, Raomondi SC, Hancock ML, et al (1991) Improved outcome in childhood acute lymphoblastic leukemia with reinforced early treatment and rotational combination chemotherapy. Lancet 337:61–66CrossRefPubMedGoogle Scholar
  4. 4.
    Henze G, Fengler R, Hartmann R, et al (1991) Six-year experience with a comprehensive approach to the treatment of recurrent childhood acute lymphoblastic leukemia (ALL-REZ BFM 85): A Relapse Study of the BFM Group. Blood 78:1166–1172PubMedGoogle Scholar
  5. 5.
    Frassoni F, Barrett AJ, Ernst P, et al (1988) Relapse after allogeneic bone marrow transplantation for acute leukaemia: a survey by the E.B.M.T. of 117 cases. Br J Haematol 70:317–320PubMedGoogle Scholar
  6. 6.
    Sanders JE (1997) Bone marrow transplantation for pediatric malignancies. Pediatr Clin N Am 44:1005–1020Google Scholar
  7. 7.
    Madani A, Christophe C, Ferster A, et al (2000) Peri-optic nerve infiltration during leukaemic relapse: MRI diagnosis. Pediatr Radiol 30:30–32CrossRefPubMedGoogle Scholar
  8. 8.
    Behrendt H, Leeuwen EF, Schuwirth C, et al (1990) Bone marrow relapse occurring at first relapse in children with acute lymphoblastic leukemia. Med Pediatr Oncol 18:190–196PubMedGoogle Scholar
  9. 9.
    Amano Y, Takaura J, Kumazaki T (1997) Case report: the MRI diagnosis of bone marrow infraction in a child with leukaemia. Clin Radiol 52:560–561PubMedGoogle Scholar
  10. 10.
    Jensen KE, Sorensen PG, Thomsen C, et al (1990) Magnetic resonance imaging of the bone marrow in patients with acute leukemia during and after chemotherapy. Acta Radiol 31:361–369PubMedGoogle Scholar
  11. 11.
    Sahdev I, Weinblatt ME, Lester H, et al (1993) Primary ocular recurrence of leukemia following bone marrow transplant. Pediatr Hematol Oncol 10:279–282PubMedGoogle Scholar
  12. 12.
    Huang LT, Hsiao CC, Went HH, et al (1996) Neurologic complications of pediatric systemic malignancies. J Formos Med Assoc 95:209–212PubMedGoogle Scholar
  13. 13.
    Chamberlain MC (1997) Pediatric leptomeningeal metastases: outcome following combined therapy. J Child Neurol 12:53–59PubMedGoogle Scholar
  14. 14.
    Bleyer WA, Byrne TN (1988) Leptomeningeal cancer in leukemia and solid tumors. Curr Probl Cancer 12:181–238PubMedGoogle Scholar
  15. 15.
    Hwang W-L, Gau J-P, Hu H-T, et al (1994) Isolated extramedullary relaps of acute lymphoblastic leukemia presenting as an intraspinal mass. Acta Haematol 91:46–48PubMedGoogle Scholar
  16. 16.
    Krepler P, Jentzsch K, Mayer-Obiditsch J (1975) Lymphoblastic extramedullary spinal tumor during remission of acute lymphoblastic leukemia. Acta Neuropathol 6[Suppl]:213–215Google Scholar
  17. 17.
    Bunin N, Rivera G, Goode F, et al (1987) Ocular relapse in the anterior chamber in childhood acute lymphoblastic leukemia. J Clin Oncol 5:299–303PubMedGoogle Scholar
  18. 18.
    Merten D (1992) Diagnostic imaging of mediastinal masses in children. AJR 158:825–832Google Scholar
  19. 19.
    Molina PL, Siegal MJ, Glazer HS (1990) Thymic masses on MR imaging. AJR 155:495–500Google Scholar
  20. 20.
    Kaste SC (2001) Lymphoma—Controversies in imaging the chest. In: Lucaya J, Strife JL (eds) Pediatric chest imaging. Chest imaging in infants and children. Springer, Heidelberg, pp 209–223Google Scholar
  21. 21.
    Fletcher BD, Kauffman WM, Kaste SC, et al (1995) Use of Tl-201 to detect untreated pediatric Hodgkin disease. Radiology 196:851–855PubMedGoogle Scholar
  22. 22.
    Fletcher BD, Xiong X, Kauffman WM, et al (1998) Hodgkin disease: use of Tl-201 to monitor mediastinal involvement after treatment. Radiology 209:471–475PubMedGoogle Scholar
  23. 23.
    Nadel HR (1993) Thallium-201 for oncologic imaging in children. Semin Nucl Med 23:243–254Google Scholar
  24. 24.
    Siegel MJ, Glazer HS, Wiener JI, et al (1989) Normal and abnormal thymus in childhood: MR imaging. Radiology 172:367–371PubMedGoogle Scholar
  25. 25.
    Boothroyd AE, Hall-Craggs MA, Dicks-Mireaux C, et al (1992) The magnetic resonance appearances of the normal thymus in children. Clin Radiol 45:378–381PubMedGoogle Scholar
  26. 26.
    Brisse H, Pacquement H, Burdairon E, et al (1998) Outcome of residual mediastinal masses of thoracic lymphomas in children: impact on management and radiological follow-up strategy. Pediatr Radiol 28:444–450CrossRefPubMedGoogle Scholar
  27. 27.
    Elkowitz SS, Leonidas JC, Lopez M, et al (1993) Comparison of CT and MRI in the evaluation of therapeutic response in thoracic Hodgkin disease. Pediatr Radiol 23:301–304PubMedGoogle Scholar
  28. 28.
    Kulkarni AG, Patil AP, Desai SR (1991) Pericardial Involvement as a presenting feature of acute myeloblastic leukemia. J Assoc Physicians India 40:345–46Google Scholar
  29. 29.
    Iemura A, Yano H, Kojiro M, et al (1991) Massive cardiac involvement of adult T-Cell leukemia/lymphoma. Arch Pathol Lab Med 115:1052-54PubMedGoogle Scholar
  30. 30.
    Handa R, Bhatia S, Wali JP, et al (1997) Acute leukemia presenting as pericardial effusion—a case report. Singapore Med J 38:491–492PubMedGoogle Scholar
  31. 31.
    Furihata M, Ido E, Iwata J, et al (1998) Adult T cell leukemia/lymphoma with massive involvement of cardiac muscle and valves. Pathol Int 48:221–224Google Scholar
  32. 32.
    Takata J, Taguchi H, Miyoshi I, et al (1998) Cardiac valve invasion in chronic adult T cell leukemia. Heart 80:311–12PubMedGoogle Scholar
  33. 33.
    Jones DP, Stapleton FB, Dalwinsky D, et al (1990) Renal dysfunction and hyperuricemia at presentation and relapse of acute lymphoblastic leukemia. Med Pediatr Oncol 18:283–286PubMedGoogle Scholar
  34. 34.
    Kebaili K, Manel AM, Chapelon C, et al (2000) Renal enlargement as presentation of isolated renal relapse in childhood leukemia. J Pediatr Hematol Oncol 22:454–45CrossRefPubMedGoogle Scholar
  35. 35.
    Chu J-Y, Cradock TV, Danis RK, et al (1981) Ovarian tumor as manifestation of relapse in acute lymphoblastic leukemia. Cancer 48:377–379Google Scholar
  36. 36.
    Franck P, Duffner U, Schulze-Seeman W, et al (1998) Testicular relapse after 13 years of complete remission of acute lymphoblastic leukemia. Urol Int 60:239–241CrossRefPubMedGoogle Scholar
  37. 37.
    Rivera GK, Pui C-H, Hancock ML, et al (1992) Update of St. Jude Study XI for childhood acute lymphoblastic leukemia. Leukemia 6[Suppl 2]:153–156Google Scholar
  38. 38.
    Pui CH, Dahl GV, Bowman WP, et al (1985) Elective testicular biopsy during chemotherapy for childhood leukemia is of no clinical value. Lancet III:410–412CrossRefGoogle Scholar
  39. 39.
    Cecalupo AJ, Frankel LS, Sullivan MP (1979) Pelvic and ovarian extramedullary leukemic relapse in young girls. Proc Am Assoc Cancer Res 20:365Google Scholar

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  1. 1.Department of Diagnostic ImagingSt. Jude Children’s Research Hospital
  2. 2.Department of RadiologyUniversity of TennesseeUSA

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