Case Report
Open Access Peer-reviewed

Leukostasis Presenting as Focal Hemorrhagic Lesions in the Brain: An Underrecognized But Life-threatening Complication of Leukemia

Singh Ria BS1,, Cotant Matthew B MD2, Krishnan Anant MD3

1Kansas City University College of Osteopathic Medicine 1750 Independence Avenue, Kansas City, Missouri, 64106

2Corewell Health William Beaumont University Hospital 3577 West 13 Mile Road, Royal Oak, Michigan, 48073

3Corewell Health William Beaumont University Hospital3601 W 13 Mile Rd, Royal Oak, Michigan, 48073

American Journal of Medical Case Reports. 2024, 12(9), 138-140. DOI: 10.12691/ajmcr-12-9-2
Received August 17, 2024; Revised September 19, 2024; Accepted September 25, 2024

Abstract

Leukostasis, which refers to increased blood viscosity due to the increased white blood cell count, is a critical condition observed in acute myeloid leukemia and is associated with significant morbidity and mortality. The excessive accumulation of white blood cells can lead to the occlusion of small vessels in various body parts such as brain and lungs, resulting in corresponding clinical symptoms. We discuss a patient with history of breast cancer and newly diagnosed leukemia whose head CT revealed multiple defined hemorrhages that were suspected to represent hemorrhagic metastasis. Findings on serial imaging and correlation with patient’s blood work, led to an alternate diagnosis of leukostasis with intracranial manifestations. This was also confirmed on the subsequent MRI. The intracranial involvement of leukostasis is rarely discussed in practice or literature such that we hope our case report will facilitate increased awareness of the condition.

Keywords:

Acute myeloid leukemia, leukostasis, hemorrhages, white blood cells, blood viscosity
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