| Organ involved |
Consequence |
Intramedullary
Bone marrow |
- BM failure (see presentation)
|
Extramedullary
Lymph nodes |
- Mediastinal adenopathy can lead to superior vena cava syndrome and respiratory distress.
|
Spleen and liver |
- Splenomegaly and further trapping of red blood cells and platelets.
- Hepatitis can be seen at diagnosis.
|
CNS |
- In less than 10% of ALL patients at diagnosis.
- Hyperleukocytosis in the peripheral blood and CSF may lead to leukostasis in CNS vasculature causing:
- Altered level of consciousness
- Predispose to cerebrovascular accident, sinovenous thrombosis, and intracranial hemorrhage.
|
Testicles |
- Painless enlargement of testes
- In 10 - 20% of boys during the course of their disease
|
Kidney |
- Rare
- Hypertension, renal failure and hematuria
- More common in T-cell
|
Gastrointestinal |
- GI bleeding commonest sign
|
| Bone and Joint |
Bone pain common due to:
- Leukemic infiltration of periosteum
- Bone infarction
- Expansion of marrow cavity
|
| Skin |
- Most common in neonates and AML
|
| Cardiac |
- Symptomatic disease in less than 5% of patients
- At autopsy series cardiac involvement 30% or so.
|
| Lung |
- Leukemic infiltrates or hemorrhage
|
