Acute lymphoblastic leukemia - orbital

Case contributed by Dr Ammar Haouimi

Presentation

Patient under chemotherapy for acute lymphoblastic leukaemia (ALL), presented with two months' history of decreased visual acuity with left proptosis

Patient Data

Age: 5 years
Gender: Male

Left proptosis (axial grade I) with retinal hemorrhage of high signal intensity on T1WI and FLAIR, and low signal intensity on T2WI and GE with no significant enhancement seen on post-contrast sequences. Diffuse thickening of the left optic nerve with perineural enhancement and intraconal fat infiltration. 

The right orbit as well as the optic chiasma appear normal.

Case Discussion

MRI features of retinal hemorrhage with leukemic infiltration of the left optic nerve in a patient with an acute lymphoblastic leukemia (ALL).

Orbital involvement is the result of an infiltration of soft tissue or orbital bone, usually seen up to 75%  of acute lymphoblastic leukemia (ALL), and up to 20% of acute myeloid leukemia (AML). MRI is more sensitive than CT in the detection of blood and blood products within the globe.

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Case information

rID: 64799
Published: 9th Dec 2018
Last edited: 10th Dec 2018
Inclusion in quiz mode: Included
Institution: Aurès Medical Imaging Center - Batna Algeria

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