From the Departments of Diagnostic Radiology (G.S.S., M.T.T., B.W.C., M.F.B., G.R., C.V., C.C.W.), Hematopathology (R.K.S.), and Leukemia (P.C.B., N.D.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1478, Houston, TX 77030.
Radiographics. 2019 Jan-Feb;39(1):44-61. doi: 10.1148/rg.2019180069.
Leukemias are malignancies in which abnormal white blood cells are produced in the bone marrow, resulting in compromise of normal bone marrow hematopoiesis and subsequent cytopenias. Leukemias are classified as myeloid or lymphoid depending on the type of abnormal cells produced and as acute or chronic according to cellular maturity. The four major types of leukemia are acute myeloid leukemia, chronic myeloid leukemia, acute lymphoblastic leukemia, and chronic lymphocytic leukemia. Clinical manifestations are due to either bone marrow suppression (anemia, thrombocytopenia, or neutropenia) or leukemic organ infiltration. Imaging manifestations of leukemia in the thorax are myriad. While lymphadenopathy is the most common manifestation of intrathoracic leukemia, leukemia may also involve the lungs, pleura, heart, and bones and soft tissues. Myeloid sarcomas occur in 5%-7% of patients with acute myeloid leukemia and represent masses of myeloid blast cells in an extramedullary location. RSNA, 2019.
白血病是骨髓中产生异常白细胞的恶性肿瘤,导致正常骨髓造血功能受损,随后出现细胞减少症。根据产生的异常细胞类型,白血病可分为髓系或淋系;根据细胞成熟程度,白血病可分为急性或慢性。四种主要类型的白血病是急性髓系白血病、慢性髓系白血病、急性淋巴细胞白血病和慢性淋巴细胞白血病。临床表现要么是骨髓抑制(贫血、血小板减少或中性粒细胞减少),要么是白血病器官浸润。白血病在胸部的影像学表现多种多样。虽然纵隔淋巴结病是胸腔内白血病最常见的表现,但白血病也可能累及肺、胸膜、心脏以及骨骼和软组织。骨髓肉瘤发生于 5%-7%的急性髓系白血病患者中,表现为骨髓原始细胞在髓外部位形成肿块。RSNA,2019。