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Peri-optic nerve infiltration during leukaemic relapse: MRI diagnosis
A Madani1, C Christophe, A Ferster
1Department of Imaging, Hôpital Universitaire des Enfants Reine Fabiola, 15 Avenue J. J. Crocq, B-1020 Brussels, Belgium.
Background:
A 10-year-old boy with a history of acute lymphoblastic leukaemia (ALL), but without previous evidence of central nervous system involvement, presented with seizures 3 years after complete remission.
Materials And Methods:
MRI showed bilateral enlargement of the optic nerves despite normal ophthalmological examination.
Results:
Only the third cerebrospinal fluid examination showed 2 % blasts without concomitant bone-marrow infiltration. Enlargement of the optic nerves was consistent with bilateral leukaemic peri-optic nerve infiltration. The appearances returned to normal after chemotherapy.
Conclusion:
The optic nerves are a potential site of relapse in patients with systemic and meningeal ALL, even in the absence of ophthalmological signs.