Highlights
- •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 .
Abstract
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.
Keywords
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References
- Chronic lymphocytic leukemia and the central nervous system: a clinical and pathological study.Neurology. 1996; 46: 19-25
- Incidence of central nervous system involvement in chronic lymphocytic leukemia and outcome to treatment.J. Neurol. 2008; 255: 828-830
- Leptomeningeal disease in chronic lymphocytic leukemia.Clin. Neurol. Neurosurg. 2007; 109: 896-901
- Chronic lymphocytic leukemia with central nervous system involvement: report of two cases with a comprehensive literature review.J Neuro.-Oncol. 2012; 106: 185-200
- Cavernous sinus syndrome.Bayl. Univ. Med. Cent. 2017; 30: 455-456
- Chronic lymphocytic leukemia with clinical debut as neurological involvement: a rare phenomenon and the need for better predictive markers.BMC Hematol. 2017; 17: 3
- Central nervous system involvement in chronic lymphocytic leukemia: uncommon manifestation with unde?ned therapeutic management.Leuk. Lymphoma. 2014; 55: 1939-1941
- Prevalence and characteristics of central nervous system involvement by chronic lymphocytic leukemia.Haematologica. 2016; 101: 458-465
- Central nervous involvement by chronic lymphocytic leukaemia.Neurol. Neurochir. Polska. 2018; 52: 228-234
- A rare case of CNS involvement with Chronic Lymphocytic Leukemia CLL.Neurol. - AAN Enterp. 2017; (P2.217)
Article info
Publication history
Published online: October 22, 2019
Accepted:
October 17,
2019
Received in revised form:
October 4,
2019
Received:
August 11,
2019
Identification
Copyright
© 2019 Elsevier B.V. All rights reserved.
