The Common, the Rare, and the Unexpected: A Review of the Spectrum of Intracranial Imaging Findings in Leukemic Patients

Leukemia is the most common childhood malignancy. It accounts for one-third of all newly diagnosed malignancies worldwide. Although it is not a disease of adulthood, it is still considered a significant cause of morbidity and mortality in both young adults and elderly patients. CNS involvement in all types of leukemia is common. Patients with CNS leukemia can initially present with neurologic symptoms or may be discovered to have CNS involvement before the onset of clinical symptoms. The role of cross sectional imaging is used to determine CNS involvement in CSF negative and new symptoms. Intracranial findings in leukemia can be classified into 2 major categories: those related to the primary disease and findings related to complications of the disease and/or medication. The type and time of diagnosis, nature and onset of symptoms, type and duration of chemotherapy, and the immune status of the patients are important variables in interpreting imaging studies. Knowledge of the range of pathologies that can involve the brain in patients whom are leukemic is essential to facilitate early diagnosis. This will aid hemoncologists in optimizing their patients' care. We present a review of intracranial imaging findings in patients whom are leukemic according to their underlying etiology and their described incidence in the literature.

Learning Objective: Identify the radiologic appearances of common and uncommon intracranial pathologies in patients with leukemia.