Leukemia

  • Etiology: hematological neoplasm caused by overproduction of immature (blasts) or abnormally differentiated cells of hematopoietic system in bone marrow that often extends into peripheral blood
  • Imaging chest:
    — Mediastinal mass
  • Imaging gastrointestinal:
    — Hepatosplenomegaly due to diffuse infiltration of liver and spleen by leukemic cells
  • Imaging spine:
    — Radiograph: diffuse osteopenia, loss of vertebral body height (vertebra plana)
    — MRI: diffuse T1 hypointense / T2 hyperintense signal with contrast enhancement (vertebral body marrow should be brighter than the disc on T1), adjacent soft tissue / leptomeningeal disease
  • Clinical: hepatosplenomegaly common at presentation of acute lymphocytic leukemia

Cases of Leukemia

CXR of acute lymphocytic leukemia with infiltration of the thymus
CXR AP+lateral shows a large anterior mediastinal mass centered in the region of the thymus.
CXR and CT of acute lymphocytic leukemia / ALL
CXR AP and lateral (above) shows left hilar and superior mediastinal lymphadenopathy which is better demonstrated on the axial CT with contrast of the chest (below).
AXR of acute lymphocytic leukemia
AXR shows diffuse enlargement of the liver and spleen.
CT and US of typhlitis
AXR AP (above left) is unremarkable. Axial CT with contrast of the abdomen (above right) shows moderate thickening of the cecum. Transverse and sagittal US of the cecum (below) shows a moderately thickened cecum lying above the right psoas muscle.
Radiograph of leukemia of the spine
Lateral radiograph of the thoracic spine shows diffuse osteopenia in the vertebral bodies with loss of height (vertebra plana) in all of the vertebral bodies.