Case report| Volume 37, 101455, January 2020

An uncommon neurological manifestation of chronic lymphocytic leukemia: Longitudinally extensive transverse myelitis

Published:October 22, 2019DOI:


      • This is a single case report of LETM during the initial phase of CLL.
      • Neurological involvement in CLL is very rare.
      • Diagnosis of CNS involvement in CLL is difficult, due to heterogeneous presentation.
      • Prognosis in CNS involvement is related to the natural history of CLL .


      We describe a 50-year-old male patient who was admitted to the emergency department with complaints of fever and fatigue that had suddenly started two weeks ago. In the laboratory evaluation, a white blood cell count of 131.000/mm3 was detected. The patient was hospitalized and developed fecal incontinence on the first day of hospitalization. Detailed neurological examination revealed the patient had tetraparesis. Long segment high signal intensity was observed on spinal MRI. Flow cytometry examination of the CSF and biopsy findings of the bone marrow were compatible with Chronic Lymphocytic Leukemia (CLL). The patient's MRI appearances resolved after treatment. The tetraparesis resolved partially. There was no motor deficit in upper extremities and the patient was able to walk without aid or rest for 100 m. Clinical manifestation of central nervous system (CNS) involvement in CLL is heterogeneous and therefore may be difficult to pinpoint. We have described an uncommon occurrence of CNS involvement in CLL.


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