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Hypopyon in acute lymphoblastic leukemia.

W S Smith, M J Burke, K Y Wong

    Medical and Pediatric Oncology
    |January 1, 1984
    PubMed
    Summary
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    Central nervous system relapse in acute lymphoblastic leukemia (ALL) can manifest as isolated eye involvement. Cytologic examination is crucial for diagnosing leukemic hypopyon, with radiotherapy being the preferred treatment.

    Area of Science:

    • Pediatric Oncology
    • Ophthalmology
    • Hematology

    Background:

    • Acute lymphoblastic leukemia (ALL) is a common childhood cancer.
    • Central nervous system (CNS) involvement is a serious complication of ALL.
    • Relapse in the CNS can occur even when bone marrow is in remission.

    Observation:

    • A pediatric patient with ALL experienced CNS relapse 23 months post-diagnosis while in bone marrow remission.
    • Isolated leukemic involvement of the eye occurred 7 months after the CNS relapse.
    • Leukemic cells formed a layer in the anterior chamber, presenting as leukemic hypopyon.

    Findings:

    • Cytologic examination was the sole method for definitive diagnosis of leukemic hypopyon.
    • Topical treatments are generally ineffective for ocular leukemia.

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  • Radiotherapy is the recommended treatment of choice for this condition.

    • Implications:

    • The prognosis of ocular leukemia depends on the timing of its occurrence relative to ALL therapy.
    • Early diagnosis and appropriate treatment are crucial for managing CNS and ocular relapse in ALL.
    • This case highlights the importance of considering ocular involvement in ALL relapse, even in the absence of systemic disease.