Peri-optic nerve infiltration during leukaemic relapse: MRI diagnosis.

BACKGROUND

A 10-year-old boy with a history of acute lymphoblastic leukaemia (ALL), but without previous evidence of central nervous system involvement, presented with seizures 3 years after complete remission.

MATERIALS AND

METHODS

MRI showed bilateral enlargement of the optic nerves despite normal ophthalmological examination.

RESULTS

Only the third cerebrospinal fluid examination showed 2 % blasts without concomitant bone-marrow infiltration. Enlargement of the optic nerves was consistent with bilateral leukaemic peri-optic nerve infiltration. The appearances returned to normal after chemotherapy.

CONCLUSION

The optic nerves are a potential site of relapse in patients with systemic and meningeal ALL, even in the absence of ophthalmological signs.