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  • Title: Disseminated necrotizing leukoencephalopathy following chemoradiation therapy for acute lymphoblastic leukemia.
    Author: Pande AR, Ando K, Ishikura R, Nagami Y, Ogawa M, Kamikonya N, Kaneda Y, Tanizawa T, Nakao N.
    Journal: Radiat Med; 2006 Aug; 24(7):515-9. PubMed ID: 17058146.
    Abstract:
    Disseminated necrotizing leukoencephalopathy (DNL) is a potentially fatal complication of treatment involving intrathecal administration of chemotherapeutic agents such as methotrexate (MTX) alone or in combination with cranial radiotherapy (RT). We describe a case of acute lymphoblastic leukemia (ALL) treated with high-dose intravenous and intrathecal methotrexate combined with craniospinal RT resulting in DNL. Typical MR imaging features of progressive deep white matter lesions showing a characteristic pattern of enhancement after contrast was seen in this case. Deep white matter lesions with ring-like enhancement and calcifications were seen on CT; it showed a mass effect at one stage, which is not typical for DNL. Long-term clinical and imaging follow-up were helpful for the diagnosis in this case.
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