T-acute lymphoblastic leukemia in a young adult complicated with unusual findings: an interesting case

A young adult diagnosed as T-acute lymphoblastic leukemia presented with unusual complications during chemotherapy. He was diagnosed to have tubercular splenic abscess and had neurologic complaints like vincristine- induced peripheral neuropathy and focal neurologic deficit complicating the course of chemotherapy. Cases of hepatosplenic tuberculosis presenting as abscesses during prolonged neutropenia in patients with acute leukemia during or after chemotherapy are rare but reported. Vincristine induced neuropathy is reported to be higher in Indian children possibly due to co-existent malnutrition. The focal lesions in the brain were intriguing as regards to the symptomatology and exact etiology especially with the limitation of imaging in such patients. This case highlights the difficulty in the course of chemotherapy due to the rare complications encountered.