Martell R W, Myers H S, Jacobs P
Br J Haematol. 1986 Jan;62(1):31-5. doi: 10.1111/j.1365-2141.1986.tb02897.x.
Radiographic abnormalities in bone are unusual during the stable phase of chronic granulocytic leukaemia (CGL). A rare situation is reported in which a patient developed three distinctive skeletal lesions simultaneously in different anatomical sites. Firstly, in both fibulae symmetrical punched out and permeative lesions were present throughout much of the shafts, being most prominent in the mid-diaphyseal regions. Secondly, the tibiae were slightly porotic and showed localized periosteal reactions, whereas in the fibulae there was extensive cloaking by a similar but much more intensive reaction. Thirdly, multiple osteosclerotic lesions were present in the pubic bones and in the proximal ends of the femora and humeri. Concurrently, fluctuant, culture negative swellings were present on the extremities. Histological examination of the material from the subcutaneous and lytic lesions showed only areas of fibrosis with islands of haematopoietic tissue, including scanty megakaryocytes. Bone marrow trephine biopsy showed the presence of myelofibrosis with islands of haematopoietic tissue typical of CGL without any evidence of blastic transformation.
在慢性粒细胞白血病（CGL）的稳定期，骨骼的影像学异常并不常见。本文报道了一种罕见情况，一名患者在不同解剖部位同时出现了三种独特的骨骼病变。首先，双侧腓骨大部分骨干出现对称性的筛孔状和浸润性病变，在骨干中部最为明显。其次，胫骨略显骨质疏松，并出现局限性骨膜反应，而腓骨则被类似但更为强烈的反应广泛覆盖。第三，耻骨、股骨近端和肱骨近端出现多处骨硬化病变。同时，四肢出现波动性、培养阴性的肿胀。对皮下和溶骨性病变组织进行组织学检查，仅显示纤维化区域伴有造血组织岛，包括少量巨核细胞。骨髓穿刺活检显示存在骨髓纤维化，伴有CGL典型的造血组织岛，未发现任何原始细胞转化的证据。
