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Disseminated necrotizing leukoencephalopathy following chemoradiation therapy for acute lymphoblastic leukemia

Radiation Medicine volume 24, pages 515–519 (2006)Cite this article

Abstract

Disseminated necrotizing leukoencephalopathy (DNL) is a potentially fatal complication of treatment involving intrathecal administration of chemotherapeutic agents such as methotrexate (MTX) alone or in combination with cranial radiotherapy (RT). We describe a case of acute lymphoblastic leukemia (ALL) treated with high-dose intravenous and intrathecal methotrexate combined with craniospinal RT resulting in DNL. Typical MR imaging features of progressive deep white matter lesions showing a characteristic pattern of enhancement after contrast was seen in this case. Deep white matter lesions with ring-like enhancement and calcifications were seen on CT; it showed a mass effect at one stage, which is not typical for DNL. Long-term clinical and imaging follow-up were helpful for the diagnosis in this case.

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Affiliations

  1. Department of Radiology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan

    Ajaya R. Pande, Kumiko Ando, Reiichi Ishikura, Yuki Nagami, Masayo Ogawa, Norihiko Kamikonya & Norio Nakao

  2. Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan

    Yumi Kaneda & Takakuni Tanizawa

Authors
  1. Ajaya R. Pande
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  2. Kumiko Ando
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  3. Reiichi Ishikura
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  4. Yuki Nagami
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  5. Masayo Ogawa
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  6. Norihiko Kamikonya
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  7. Yumi Kaneda
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  8. Takakuni Tanizawa
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  9. Norio Nakao
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Corresponding author

Correspondence to Ajaya R. Pande.

Additional information

This work was presented at the 280th Japan Radiological Society meeting, Chihokai Kansai, July 2, 2005

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Pande, A., Ando, K., Ishikura, R. et al. Disseminated necrotizing leukoencephalopathy following chemoradiation therapy for acute lymphoblastic leukemia. Radiat Med 24, 515–519 (2006). https://doi.org/10.1007/s11604-006-0059-5

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  • DOI: https://doi.org/10.1007/s11604-006-0059-5

Key words

  • ALL
  • Methotrexate
  • Radiotherapy
  • Leukoencephalopathy
  • MRI