A Case of Acute Lymphocytic Leukemia (FAB-L3) with the Initial Symptom of Spinal Cord Transverse Syndrome

Abstract

A 21-year-old man was admitted to our hospital because of a rapidly progressed spinal cord transverse syndrome. He had been well until he began to suffer from lumbago and weakness of lower extremities only one week before the admission. Firstly he was diagnosed of having a spinal cord tumor by myelography. After an operation could reveal no significant lesions except dural thickening, lymphoblasts appeared rapidly with anemia and thrombocytopenia. Hematologic scrutiny convicted us that the patient had acute lymphocytic leukemia (FAB-L3). He died of infection and bleeding with no remission by chemotherapy. The autopsy disclosed necrotizing myelopathy with massive infiltration of the blasts into the spinal cord. Literature review suggests that acute lymphocytic leukemia may cause spinal cord involvement by direct infiltration, not by compression which is more frequent in chloromas or lymphomas.