Bone marrow infiltrative disease (leukemia)

Case contributed by Dr Nesma Adel Zeed

Presentation

Low back and hip pain. Elevated white cell and reduced platelet counts.

Patient Data

Age: 35 years
Gender: Male

Diffuse replacement of the normal bone marrow signal intensity of examined parts of the skeleton (lower lumbar spine, sacrum, pelvic bones and both femora).

It displays diffuse low signal intensity on T1WI, heterogeneous high signal intensity on T2WI with no signal suppression on T2 fat sat indicative of reconversion or infiltration of yellow bone marrow.

Case Discussion

Leukemia includes a heterogeneous group of neoplasms that infiltrate bone marrow with mature or immature cells of the white blood cell lineage. In leukemia, bone marrow infiltration usually occurs diffusely, with a diffuse decrease in the marrow signal intensity on T1-weighted images. MRI is highly sensitive for detecting bone marrow infiltration, but its specificity is poor, leaving the diagnosis of leukemia to peripheral blood smears and bone marrow biopsy.

T1-weighted imaging is the most sensitive pulse sequence to assess abnormal bone marrow signal intensity.

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Case information

rID: 62121
Published: 13th Aug 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Dr Osama Dawoud Radiology center

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