ArticleLeukemia research reports2026
A fatal posterior-fossa chloroma masquerading as tuberculous meningitis after peripartum BCR-ABL1 inhibitor cessation - a case report.
Article in Leukemia research reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Intracranial myeloid sarcoma complicating chronic myeloid leukemia (CML) is exceptional; when its cerebrospinal-fluid profile simultaneously mimics tuberculous meningitis (TBM), the diagnostic trap becomes fatal. A 27-year-old postpartum woman with Ph⁺ CML, initially presenting in B-cell acute lymphoblastic leukemia lymphoid blast crisis, developed rapidly progressive posterior-fossa syndrome following peripartum tyrosine kinase inhibitor (TKI) discontinuation. CSF revealed lymphocyte-predominant pleocytosis, hypoglycorrhachia, hyperproteinorachia, and adenosine deaminase 33 U/L, with negative CBNAAT, malignant cytology, and flow cytometry; BCR-ABL1 P210 registered an International Scale of 49.196%. Contrast-enhanced MRI demonstrated a dural-based, homogeneously enhancing, diffusion-restricting cerebellopontine mass with pachymeningeal involvement, consistent with granulocytic sarcoma. Death from tonsillar herniation occurred within one week, before tissue confirmation. Three imperatives emerge: CSF adenosine deaminase elevation lacks specificity for TBM in hematological malignancy; Ph⁺ CML can undergo myeloid CNS relapse following peripartum TKI cessation; and a posterior-fossa dural mass in leukemia demands urgent tissue diagnosis.
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