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Leukemia: Bone Changes
Behrang Amini, MD, PhD; B. J. Manaster, MD, PhD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Clinical Issues

        • Diagnostic Checklist

          TERMINOLOGY

          • Abbreviations

            • Acute lymphocytic leukemia (ALL)
            • Chronic lymphocytic leukemia (CLL)
            • Acute myelogenous leukemia (AML)
            • Chronic myelogenous leukemia (CML)
          • Synonyms

            • Granulocytic sarcoma, chloroma
          • Definitions

            • Leukemia: neoplastic disorder of white blood cells
              • May be myeloid or lymphoid in origin
              • May be acute or chronic
            • Granulocytic sarcoma (chloroma): mass of malignant primitive myeloid cells

          IMAGING

          • General Features

            • Radiographic Findings

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        Selected References

                                        1. Tannenbaum MF et al: Imaging musculoskeletal manifestations of pediatric hematologic malignancies. AJR Am J Roentgenol. 214(2):455-64, 2020
                                        2. Meyer HJ et al: Clinical and imaging features of myeloid sarcoma: a German multicenter study. BMC Cancer. 19(1):1150, 2019
                                        3. Fiz F et al: Adult advanced chronic lymphocytic leukemia: computational analysis of whole-body CT documents a bone structure alteration. Radiology. 271(3):805-13, 2014
                                        4. Chen BB et al: Dynamic contrast-enhanced MR imaging measurement of vertebral bone marrow perfusion may be indicator of outcome of acute myeloid leukemia patients in remission. Radiology. 258(3):821-31, 2011
                                        5. Adamson PC: Imaging in early phase childhood cancer trials. Pediatr Radiol. 39 Suppl 1:S38-41, 2009
                                        6. Berger FH et al: Diffuse marrow changes. Semin Musculoskelet Radiol. 13(2):104-10, 2009
                                        7. Desmond R et al: Multiple vertebral collapse as a presentation of childhood acute lymphoblastic leukaemia. Br J Haematol. 144(5):627, 2009
                                        8. Shih TT et al: Bone marrow angiogenesis magnetic resonance imaging in patients with acute myeloid leukemia: peak enhancement ratio is an independent predictor for overall survival. Blood. 113(14):3161-7, 2009
                                        9. Tafaghodi F et al: Predictive plain x-ray findings in distinguishing early stage acute lymphoblastic leukemia from juvenile idiopathic arthritis. Clin Rheumatol. 28(11):1253-8, 2009
                                        10. Baur-Melnyk A et al: Oncohaematologic disorders affecting the skeleton in the elderly. Radiol Clin North Am. 46(4):785-98, vii, 2008
                                        11. Buck AK et al: First demonstration of leukemia imaging with the proliferation marker 18F-fluorodeoxythymidine. J Nucl Med. 49(11):1756-62, 2008
                                        12. Donovan A et al: Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as septic arthritis of the shoulder. Skeletal Radiol. 37(11):1035-9, 2008
                                        13. Merrow AC et al: Leukemia and treatment: imprint on the growing skeleton. Pediatr Radiol. 38(5):594, 2008
                                        14. Sato TS et al: Primary multifocal osseous lymphoma in a child. Pediatr Radiol. 38(12):1338-41, 2008
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Clinical Issues

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Abbreviations

                                                  • Acute lymphocytic leukemia (ALL)
                                                  • Chronic lymphocytic leukemia (CLL)
                                                  • Acute myelogenous leukemia (AML)
                                                  • Chronic myelogenous leukemia (CML)
                                                • Synonyms

                                                  • Granulocytic sarcoma, chloroma
                                                • Definitions

                                                  • Leukemia: neoplastic disorder of white blood cells
                                                    • May be myeloid or lymphoid in origin
                                                    • May be acute or chronic
                                                  • Granulocytic sarcoma (chloroma): mass of malignant primitive myeloid cells

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • CT Findings

                                                      • MR Findings

                                                        • Nuclear Medicine Findings

                                                          • Imaging Recommendations

                                                            DIFFERENTIAL DIAGNOSIS

                                                              PATHOLOGY

                                                              • General Features

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              Selected References

                                                                              1. Tannenbaum MF et al: Imaging musculoskeletal manifestations of pediatric hematologic malignancies. AJR Am J Roentgenol. 214(2):455-64, 2020
                                                                              2. Meyer HJ et al: Clinical and imaging features of myeloid sarcoma: a German multicenter study. BMC Cancer. 19(1):1150, 2019
                                                                              3. Fiz F et al: Adult advanced chronic lymphocytic leukemia: computational analysis of whole-body CT documents a bone structure alteration. Radiology. 271(3):805-13, 2014
                                                                              4. Chen BB et al: Dynamic contrast-enhanced MR imaging measurement of vertebral bone marrow perfusion may be indicator of outcome of acute myeloid leukemia patients in remission. Radiology. 258(3):821-31, 2011
                                                                              5. Adamson PC: Imaging in early phase childhood cancer trials. Pediatr Radiol. 39 Suppl 1:S38-41, 2009
                                                                              6. Berger FH et al: Diffuse marrow changes. Semin Musculoskelet Radiol. 13(2):104-10, 2009
                                                                              7. Desmond R et al: Multiple vertebral collapse as a presentation of childhood acute lymphoblastic leukaemia. Br J Haematol. 144(5):627, 2009
                                                                              8. Shih TT et al: Bone marrow angiogenesis magnetic resonance imaging in patients with acute myeloid leukemia: peak enhancement ratio is an independent predictor for overall survival. Blood. 113(14):3161-7, 2009
                                                                              9. Tafaghodi F et al: Predictive plain x-ray findings in distinguishing early stage acute lymphoblastic leukemia from juvenile idiopathic arthritis. Clin Rheumatol. 28(11):1253-8, 2009
                                                                              10. Baur-Melnyk A et al: Oncohaematologic disorders affecting the skeleton in the elderly. Radiol Clin North Am. 46(4):785-98, vii, 2008
                                                                              11. Buck AK et al: First demonstration of leukemia imaging with the proliferation marker 18F-fluorodeoxythymidine. J Nucl Med. 49(11):1756-62, 2008
                                                                              12. Donovan A et al: Chronic lymphocytic leukemia/small lymphocytic lymphoma presenting as septic arthritis of the shoulder. Skeletal Radiol. 37(11):1035-9, 2008
                                                                              13. Merrow AC et al: Leukemia and treatment: imprint on the growing skeleton. Pediatr Radiol. 38(5):594, 2008
                                                                              14. Sato TS et al: Primary multifocal osseous lymphoma in a child. Pediatr Radiol. 38(12):1338-41, 2008