Necrotic Bone Involvement in an Adult Afflicted with B-Cell Precursor Acute Lymphoblastic Leukemia Mimicking Osteomyelitis: A Case Report
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±èÇý¿ø(Kim Hae-Won) - Catholic University College of Medicine Yeouido St. Mary¡¯s Hospital Department of Radiology
±Ç¼ø¿ë(Kwon Soon-Yong) - Catholic University College of Medicine Yeouido St. Mary¡¯s Hospital Department of Orthopaedic Surgery
Á¤¿ä¼Á(Chong Yo-Sep) - Catholic University College of Medicine Yeouido St. Mary¡¯s Hospital Department of Hospital Pathology
¹ÚÁ¤¹Ì(Park Jeong-Mi) - Catholic University College of Medicine Yeouido St. Mary¡¯s Hospital Department of Radiology
Abstract
A 41-year-old female presented with complaint of left hip and buttock pain. Magnetic resonance imaging (MRI) showed multi-focal bone marrow signal intensity changes in left iliac bone, sacrum and femur with an area of necrosis. The primary radiological differential diagnosis was multi-focal tuberculous osteomyelitis. Subsequent pelvic bone biopsy and bone marrow biopsy confirmed the diagnosis of B-cell precursor acute lymphoblastic leukemia with extensive necrosis, which is infrequent in leukemia. When musculoskeletal symptoms precede peripheral blood abnormalities and MRI scanning reveals multi-focal necrotic lesions rather than diffuse signal change, it can be difficult to identify and/or advance leukemia as differential diagnosis.
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Precursor B-Cell Lymphoblastic Leukemia-Lymphoma, Necrosis, Magnetic Resonance Imaging
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After MRI, subsequent pelvic bone biopsy and bone marrow biopsy confirmed the diagnosis of B-cell precursor acute lymphoblastic leukemia with extensive necrosis, which is infrequent in leukemia.