Pathologic correlations of otologic symptoms in acute lymphocytic leukemia

• Published in: American journal of otolaryngology Vol. 32; no. 1; pp. 13 - 18
• Main Authors: Terao, Kyoichi, MD, PhD, Cureoglu, Sebahattin, MD, Schachern, Patricia A., BS, Paparella, Michael M., MD, Morita, Norimasa, MD, PhD, Nomiya, Shigenobu, MD, PhD, Inagaki, Taro, MD, PhD, Mori, Kazunori, MD, PhD, Murata, Kiyotaka, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 2011; Elsevier; Elsevier Limited
• Subjects: Adolescent; Adult; Aged; Autopsy; Biological and medical sciences; Cause of Death; Chemotherapy; Child; Child, Preschool; Complaints; Ear diseases; Ear Diseases - pathology; Ears & hearing; Female; Hearing loss; Hematologic and hematopoietic diseases; Hemorrhage; Hemorrhage - pathology; Humans; Inflammation - pathology; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukemic Infiltration - pathology; Male; Medical sciences; Membranes; Middle Aged; Otolaryngology; Otorhinolaryngology. Stomatology; Precursor Cell Lymphoblastic Leukemia-Lymphoma - pathology; Surgery; Temporal Bone - pathology; Vertigo; Symptomatology; Malignant hemopathy; ENT; Acute lymphocytic leukemia; Lymphoproliferative syndrome; Cancer
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2009.08.006

Abstract Objectives To assess the clinicopathologic correlations of otologic complaints in patients with acute lymphocytic leukemia. Design Otologic complaints and histologic findings were evaluated in 25 temporal bones of 13 acute lymphocytic leukemia patients. Results Nine patients had a history of otologic complaints, including hearing loss, otalgia, otorrhea, and vertigo in 5, 3, 3, and 2 patients, respectively. Hemorrhage was most commonly observed in the middle ear (6 patients, 9 temporal bones) and was also observed in cochlea (4 patients, 4 temporal bones), and vestibule (6 patients, 6 temporal bones). Leukemic infiltration was observed in the petrous apex (13 patients, 24 temporal bones), middle ear (7 patients, 14 temporal bones), cochlea (3 patients, 4 temporal bones), vestibule (3 patients, 4 temporal bones), and internal auditory canal (5 patients, 8 temporal bones). Inflammatory changes were observed in the cochlea (5 patients, 8 temporal bones) and vestibule (5 patients, 8 temporal bones). Middle ear effusion containing floating tumor cells was observed in 4 temporal bones of 3 patients. Irreversible histopathologic changes of the middle ear, such as the destruction of the ossicles, perforation of the tympanic membrane, and granulation tissues were observed in 5 temporal bones of 4 patients. Conclusions Ear involvement is common in acute lymphocytic leukemia patients. With prolonged survival due to the progress of treatment, the diagnosis and treatment of nonhematopoietic system symptoms, such as ear problems due to acute lymphocytic leukemia, have become more important.