Myelodysplastic syndrome with osteomyelosclerosis

Case contributed by Björn Jobke
Diagnosis certain


Shortness of breath. Imaging performed to exclude pulmonary embolus. Known myelodysplastic syndrome.

Patient Data

Age: 70 years
Gender: Female

CT in the bone window demonstrates dense, somewhat inhomogeneous bone structure throughout the skeleton. This is especially pronounced in the spine.

Splenomegaly is also present.

Case Discussion

The patient has a known myelodysplastic syndrome. This may be seen on imaging as myelofibrosis of the bone marrow and osteomyelosclerosis in the long term, as presented in this case. The osteosclerosis is diffuse but inhomogeneous throughout the skeleton. A reduction of active hematopoietic marrow leads to anemia and possible extramedullary hematopoiesis as well as splenomegaly.  Myelodysplastic syndrome may convert into leukemia later in life. Also, pulmonary hypertension may be seen in patients with myelofibrosis; this may be the cause for this patient's pulmonary symptoms. 

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