Acute promyelocytic leukemia with an intracerebral mass and meningeal involvement after treatment of non‐Hodgkin's lymphoma

Abstract

After a 3‐month leukopenic phase, a patient developed hematologic pictures of acute promyelocytic leukemia (APL). Treatment with chemotherapy and radiotherapy had been given 10 months previously for a non‐Hodgkin's lymphoma (NHL) of diffuse large cell type arising in the Waldeyer's ring. A computed tomographic scan demonstrated a high density mass in the left frontal cerebrum, which was enhanced uniformly by the contrast material. Cytocentrifuge examination of cerebrospinal fluid also showed an excess of promyelocytes. From these observations, the mass was considered to be an infiltration of leukemic cells. The intracerebral mass and meningeal involvement were resolved concomitantly with a hematologic remission of APL after intrathecal injection of cytosine arabinoside and systemic combination chemotherapy. This is a particular case of APL previously undescribed, representing an unusual presentation with intracerebral APL mass as well as a rare posttherapeutic APL following NHL. Cancer 59:94–98, 1987. Copyright © 1987 American Cancer Society