Multiple Hepatic Lesions During Acute Leukemia Remissions

The US and CT manifestations of multiple small hepatic lesions of 15 patients during their remissions following chemotherapy for acute leukemia were reviewed. Liver biopsies established the diagnoses in 5 of the 15 patients. Despite their remissions, two cases had leukemic involvement. Others had microabscesses, 2 due to candida and 1 due to peptostreptococcus.
Ultrasonographically, the microabscesses and leukemic involvement in the liver consisted of multiple round hypoechoic and target-like masses. With CT, these appeared as multiple zones of diminished attenuation. Only distal acoustic enhancement with US could differentiate these disease processes.