Acute leukemia presenting with blasts first found in the cerebrospinal fluid but not in the peripheral blood
we report nine patients with acute leukemia, symptoms suggestive of involvement of multiple cranial nerves, the spinal cord, and meningeal involvement. Moreover, we found that all these patients unexpectedly showed the presence of blasts in the cerebrospinal fluid (CSF) but not in the peripheral blood despite repeated examinations. Bone marrow examination confirmed the presence of acute leukemia in these patients. .
Journal of Clinical Neuroscience Volume 17, Issue 10 , October 2010, Pages 1252-1255
Intracranial masses may occur in leukemia, although they are rare. Chloromas (granulocytic sarcoma, myeloblastoma) are masses composed of immature granulocytic cells. These lesions were first described by Burns in 1811 and named for their greenish colon on gross inspection.
Granulocytic sarcoma occurs primarily in patients with acute myelogenous leukemia .