Complications of Hematologic Malignancies in the Emergency Department: A Primer for the Radiologist

Hematologic malignancies, including diseases such as Hodgkin and non-Hodgkin lymphoma, acute and chronic lymphocytic and myelogenous leukemia, and multiple myeloma, comprise a set of prevalent and clinically diverse diseases that can affect any organ system.1 Acute life-threatening oncologic emergencies can result secondary to the underlying disease or as a result of complications of therapy, and they are common in patients with hematologic malignancies. Oncologic emergencies can be categorized as metabolic, hematologic, and structural conditions.2 Although metabolic and hematologic emergencies are diagnosed most often on the basis of clinical and laboratory findings, imaging plays a significant role in determining the underlying cause for these entities. Imaging studies play a critical role in diagnosing structural pathologic conditions, which can result in bleeding, mechanical compression, or obstruction to the hollow organs. Radiologists should be aware of the acute clinical presentations of hematologic malignancies to make an accurate, timely diagnosis and provide appropriate patient care. This article reviews, in a systematic, organ-based approach, the acute metabolic and mechanical emergencies encountered in the emergency department in patients with hematologic malignancies.