Acute myeloid leukemia CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2], Carlos A Lopez, M.D. [3], Shyam Patel [4]; Grammar Reviewer: Natalie Harpenau, B.S.[5]

Overview

Abdominal and chest CT scan may be helpful in the diagnosis of acute myeloid leukemia. Findings on CT scan suggestive of acute myeloid leukemia or myeloid sarcoma include enlarged lymph nodes, hepatosplenomegaly, splanchnic venous thrombosis, and pulmonary embolism.

CT

Abdominal and chest CT scan may be helpful in the diagnosis of acute myeloid leukemia. CT can assist with detection of:

  • Lymphadenopathy: Malignant hematologic disease is commonly associated with enlargement of lymph nodes. CT can quantify the degree of lymphadenopathy and can accurate measure lymph node size.
  • Splenomegaly: Enlargement of the spleen is sometimes found in patients with acute myeloid leukemia, as extramedullary hematopoiesis occurs in the spleen.[1] CT can quantitate spleen size, and serial CTs are sometimes useful for assessment of interval changes in clinical condition. CT of the abdomen is more sensitive that abdominal ultrasound for detection of splenomegaly, although the cost of CT is higher and there is a risk for radiation-induced cancers.
  • Hepatomegaly: CT can quantitate liver size. This is sometimes useful in patients with acute myeloid leukemia or other myeloproliferative disorders.[1]
  • Splanchnic venous thrombosis: Patients with acute myeloid leukemia can develop thromboses at unusual sites, including mesenteric vasculature such as the portal vein, superior mesenteric vein, and inferior mesenteric vein.
  • Pulmonary embolism: CT angiography of the chest is the optimal test for assessment for thrombosis of the pulmonary vasculature. Venous thromboembolism events are common in patients with acute promyelocytic leukemia, since these patients can have activation of the coagulation cascade.[2]

References

  1. 1.0 1.1 Mitra D, Kaye JA, Piecoro LT, Brown J, Reith K, Mughal TI; et al. (2013). "Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review". Cancer Med. 2 (6): 889–98. doi:10.1002/cam4.136. PMC 3892393. PMID 24403262.
  2. Falchi L, Kantarjian HM, Verstovsek S (2017). "Assessing the thrombotic risk of patients with essential thrombocythemia in the genomic era". Leukemia. 31 (9): 1845–1854. doi:10.1038/leu.2017.150. PMC 5989314. PMID 28529308.

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