Department of Hematology, Graduate School of Medicine, Osaka City University, Japan.
Department of Clinical Laboratory, Osaka City University Hospital, Japan.
Intern Med. 2021 Apr 1;60(7):1083-1088. doi: 10.2169/internalmedicine.5815-20. Epub 2020 Oct 28.
Bone marrow necrosis (BMN) is a rare but important complication of hematological malignancies. We report the case of a 52-year-old male patient with a recurrence of acute lymphoblastic leukemia (ALL) accompanied by BMN. After re-induction therapy, bone marrow aspiration (BMA) and biopsy from the iliac bone showed necrotic cells and eosinophilic debris, respectively. Magnetic resonance imaging (MRI) showed heterogeneous signals in the bilateral iliac bone, possibly reflecting various stages of BMN. BMA from the sternum eventually revealed the recurrence of ALL after a few weeks. Comprehensive assessments, including MRI and repeated bone marrow tests, are required when evaluating the underlying hematological malignancies of patients with BMN.
骨髓坏死 (BMN) 是一种罕见但重要的血液系统恶性肿瘤并发症。我们报告了一例 52 岁男性患者，其急性淋巴细胞白血病 (ALL) 复发并伴有 BMN。在重新诱导治疗后，髂骨骨髓抽吸 (BMA) 和活检分别显示坏死细胞和嗜酸性碎片。磁共振成像 (MRI) 显示双侧髂骨信号不均匀，可能反映了 BMN 的不同阶段。几周后，胸骨的 BMA 最终显示 ALL 复发。当评估 BMN 患者的基础血液系统恶性肿瘤时，需要进行包括 MRI 和重复骨髓检查在内的综合评估。
