Table 1 Baseline and clinical features of patients with Leukemia complicated by central nervous system lesions
Case | Age | Gender | Leukemia | Clinical Manifestations | Imaging Features | Clinical Diagnosis | Pathological Diagnosis |
|---|---|---|---|---|---|---|---|
1 | 15 | M | AML(M5) | Seizures | Multiple cystic-solid lesions in the right frontal lobe and left occipital lobe, with enhanced cyst walls. Diffusion imaging shows high signal intensity within the lesions | Brain abscess | Brain abscess (Fungal) |
2 | 20 | M | ALL | Headache, Vomitig, Seizures | Multiple nodular lesions with long T1 and long T2 signals in the cortex and subcortex of both cerebral hemispheres, with unclear boundaries. There is evident perilesional edema. Enhancement scan reveals multiple nodular enhancements resembling "small cysts" | CSNL | Brain abscess (Fungal) |
3 | 39 | M | ALL | Headache, Vomiting, Lethargy | Abnormal mixed patchy signal adjacent to the right temporal horn of the lateral ventricle, with mixed T1 and long T2 signals, surrounding brain tissue edema, partial enhancement. Additionally, multiple small circular lesions adjacent to the left posterior horn of the lateral ventricle, exhibiting small volume, short T1 and long T2 signals, surrounded by brain tissue edema, and ring enhancement | Neurodegenerative disease | Brain abscess (Fungal) |
4 | 26 | F | AML (M4) | Fever, Headache, Slurred speech, Mouth drooping, Seizures, Loss of consciousness | Mixed signal intensity at the junction of the left frontal, temporal, and parietal lobes, measuring 4.3 × 4.5 cm, with prominent enhancement of the lesion and surrounding brain tissue edema | CSNL | Brain abscess (unknown pathogen) |
5 | 43 | F | ALL | Headache | Prominent enhancing mass lesion in the right frontal lobe, measuring 3.1 × 3.5 cm, accompanied by significant edema in the surrounding brain tissue | CSNL | Tuberculoma |
6 | 49 | M | ALL (B cell) | / | Enhanced lesions with surrounding edema in the left parietal and occipital lobes, and a softening lesion in the right parietal lobe | CSNL | Gliosis |
7 | 71 | M | AML | Sudden onset of right-sided limb movement impairment | The lesion in the right frontal lobe demonstrates long T1 and long T2 signals, with prominent ring enhancement on contrast-enhanced scans, but no internal enhancement | CSNL | Gliosis |
8 | 60 | M | CLL (B cell) | Limb weakness, unsteady gait | Patchy abnormal signals in the left pontine and cerebellar hemispheres, with scattered patchy abnormal signals around the bilateral lateral ventricles, demonstrating short T1 and long T2 signals without mass effect. Partial enhancement is observed in the lesions of the left pontine and cerebellar hemispheres | Neurodegenerative disease | Demyelinating lesion |
9 | 23 | F | ALL (B cell) | Headache | Lesions with long T1 and long T2 signals are observed in the right lateral ventricular frontal horn white matter, with unclear boundaries. There is no significant edema, and no enhancement is seen on contrast-enhanced scans | Neurodegenerative disease | Demyelinating lesion |
10 | 22 | M | ALL(B cell) | Dizziness with double vision, Vomiting, Unsteady gait | Abnormal patchy or nodular signals are observed in the left medulla oblongata, pons, midbrain, bilateral cerebellar hemispheres, bilateral thalami, splenium of the corpus callosum, periventricular regions, cortical and subcortical areas of the right frontal and parietal lobes, and left parietal and occipital lobes. These lesions show significant enhancement | Neurodegenerative disease | B-cell lymphoblastic leukemia involving CNS |
11 | 7 | M | ALL (B cell) | Headache, Dizziness | Cystic mass lesion in the right temporal-occipital region, with surrounding brain tissue edema | Brain abscess | B-cell lymphoblastic leukemia involving CNS |
12 | 54 | M | ALL (B cell) | Headache, Limb numbness, Vomiting, Seizures | Patchy enhancing lesions are visible in the posterior parts of both parietal lobes, and the meninges demonstrate "gyriform" enhancement pattern | CSNL | B-cell lymphoblastic leukemia involving CNS |
13 | 25 | M | ALL (T cell) | Headache, Seizures, Limb Weakness, Decreased vision in both eyes | There is a mass lesion in the right hemisphere of the brain, with mild enhancement around the lesion and ventricular dilation | CSNL | T-cell lymphoblastic leukemia involving CNS |
14 | 60 | M | CMML | Nausea, Vomiting, Right-sided limb weakness, Altered consciousness | A 2.5 × 3 cm mass lesion is visible in the left basal ganglia and thalamus, protruding into the left ventricle and invading the corpus callosum. The left ventricle is deformed due to compression, with significant enhancement of the lesion | CSNL | Chronic myeloid leukemia involving CNS |
15 | 26 | M | ALL(B cell) | Headache | Multiple lesions are observed in the left temporal lobe, accompanied by surrounding brain tissue edema and meningeal enhancement | CSNL | B-cell lymphoblastic leukemia involving CNS |
16 | 29 | F | AML(M5) | / | Abnormal mass-like signals are present in both cerebral hemispheres, with abnormal enhancing signals observed in both cerebellar hemispheres and the left occipital lobe | CSNL | Myeloid leukemia involving CNS |
17 | 42 | M | ALL(B cell) | Dizziness, Vomiting, Unsteady gait | Nodular enhancing lesions are visible in the vermis of the cerebellum, the roof of the fourth ventricle, and the left cerebellar hemisphere | CSNL | B-cell lymphoblastic leukemia involving CNS |
18 | 39 | M | ALL(B cell) | Headache | There is a slightly long T1 and short T2 lesion in the right cerebellar hemisphere, which enhances after contrast administration. The enhancement is uneven, and the border is unclear. The size of the mass is approximately 6 cm | CSNL | B-cell lymphoblastic leukemia involving CNS |
19 | 26 | M | ALL(B cell) | Headache | Multiple mass-like lesions with slightly long T1 and slightly short T2 signals are visible in the left temporal lobe, with small punctate short T1 signals within. There is significant surrounding edema extending to the thalamus and basal ganglia. The lesions exhibit marked enhancement, which is uneven, with slightly higher enhancement along the edges | CSNL | B-cell lymphoblastic leukemia involving CNS |
20 | 29 | M | ALL(T cell) | Headache | There are long T1 and long T2 signals in the left temporal lobe and the lateral wall of the left orbital cavity, with uneven enhancement. The enhanced portion of the left temporal lobe exhibits peripheral low signal. The left optic nerve is compressed | CSNL | T-cell lymphoblastic leukemia involving CNS |
21 | 7 | M | ALL(B cell) | / | There are multiple thickened lesions in the midbrain, pons, and medulla oblongata. Nodular enhancement is evident in the central part of the pontine lesion, with mild linear enhancement observed around it | CSNL | B-cell lymphoblastic leukemia involving CNS |
22 | 32 | M | AML(M5) | Dizziness, Headache | There are abnormal nodular or patchy masses in the right temporal lobe and the left cerebellar hemisphere. These masses exhibit short T1 and long T2 signals and show uniform enhancement. There is significant surrounding brain tissue edema | CSNL | Myeloid leukemia involving CNS |