Multisystem Radiological Manifestations of Acute Leukemias: A Pictorial Essay

Acute leukemias are aggressive hematological malignancies characterized by uncontrolled proliferation of immature myeloid or lymphoid precursor cells. Although bone marrow involvement remains the hallmark of disease, extramedullary manifestations and disease-related complications may affect multiple organ systems and contribute significantly to morbidity and mortality. Computed tomography and magnetic resonance imaging play a pivotal role in the detection, characterization, and assessment of disease extent. This pictorial essay illustrates the diverse imaging spectrum of acute leukemias through representative cases involving the central nervous system, orbit, eye, skeletal muscle, peripheral nerves, paravertebral and epidural soft tissues, gastrointestinal tract, and mediastinum. Recognition of these imaging appearances is essential for early diagnosis, prompt therapeutic intervention, and improved patient outcomes.