The Usefulness of T1-Weighted Magnetic Resonance Images for Diagnosis of Acute Leukemia Manifesting Musculoskeletal Symptoms prior to Appearance of Peripheral Blood Abnormalities
| Autor: | Nanae Tanaka, Taihei Hayashi, Yoshihiro Taniguchi, Takehiko Sakai, Toshihide Yoshikawa, Yusei Ohshima, Naoko Kikuchi, Koji Suzuki, Masayo Tsuda, Hiroyuki Okamoto, Akihiko Tanizawa, Genrei Ohta |
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| Rok vydání: | 2016 |
| Předmět: |
Pathology
medicine.medical_specialty Case Report 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine Peripheral blood cell Bone pain 030222 orthopedics Acute leukemia medicine.diagnostic_test business.industry Osteomyelitis lcsh:RJ1-570 lcsh:Pediatrics Magnetic resonance imaging General Medicine medicine.disease Bone marrow examination Leukemia medicine.anatomical_structure Bone marrow Radiology medicine.symptom business |
| Zdroj: | Case Reports in Pediatrics, Vol 2016 (2016) Case Reports in Pediatrics |
| ISSN: | 2090-6811 2090-6803 |
| DOI: | 10.1155/2016/2802596 |
| Popis: | The patients with acute leukemia occasionally present with musculoskeletal symptoms initially, including bone pain, joint pain, muscular pain, and functional impairment. Without abnormal findings of peripheral blood cell counts or smear, the correct diagnosis tends to be delayed. Magnetic resonance imaging is often performed to examine musculoskeletal abnormalities; it can simultaneously reveal the bone marrow composition with high anatomical resolution and excellent soft tissue contrast. We present 4 pediatric patients who were initially diagnosed with acute pyogenic osteomyelitis or arthritis, based on the elevated white blood cell counts and/or C-reactive protein in addition to the localized high signal intensity on T2-weighted magnetic resonance images. Finally, they were diagnosed with B-cell precursor acute lymphoblastic leukemia by bone marrow examination. The period between the onset of musculoskeletal symptoms and the diagnosis of leukemia ranged from 20 days to 6 months. In all cases, the T1-weighted magnetic resonance images taken prior to detection of peripheral blood abnormality revealed diffuse low signal intensity of the bone marrow in regions adjacent or contralateral to localized musculoskeletal symptoms. These findings should raise the suspicion of leukemia even without abnormalities in peripheral blood. |
| Databáze: | OpenAIRE |
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