Pathologic correlations of otologic symptoms in acute lymphocytic leukemia☆
Received 30 June 2009 published online 21 December 2009. Corrected Proof
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.
aDepartment of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
bInternational Hearing Foundation, Minneapolis, Minnesota, USA
cDepartment of Otolaryngology, Kinki University School of Medicine, Osaka, Japan
dPaparella Ear Head and Neck Institute, Minneapolis, Minnesota, USA
Corresponding author. Department of Otolaryngology, University of Minnesota, Room 210, Lions Research Building, 2001, 6th Street, SE, Minneapolis, MN 55455, USA. Tel.: +1 612 626 9883; fax: +1 612 626 9871.
☆ This study was supported by the International Hearing Foundation, the Starkey Foundation, and the Society for Promotion of International Oto-Rhino-Laryngology.
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