Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Division of Pediatric Hematology/Oncology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
BMJ Case Rep. 2021 Dec 31;14(12):e247506. doi: 10.1136/bcr-2021-247506.
Paediatric patients with acute myeloid leukaemia (AML) often present with symptoms associated with the disruption of normal haematopoiesis and subsequent cellular deficiencies. Periosteal reactions are common in paediatric leukaemia, but typically manifest as a thin, laminated pattern along long bones. Aggressive periosteal reactions are much less frequently seen. Here, we report a case of paediatric AML initially presenting with proptosis and periorbital swelling caused by aggressive, sunburst periosteal reactions surrounding the sphenoid and zygomatic bones. This unique presentation emphasises the importance of considering leukaemic infiltration in the differential for sunburst periosteal reaction in paediatric patients.
患有急性髓系白血病(AML)的儿科患者常出现与正常造血功能紊乱和随后的细胞缺陷相关的症状。骨膜反应在儿科白血病中很常见,但通常表现为长骨上的薄、层状模式。侵袭性骨膜反应则少见得多。在这里,我们报告了一例儿科 AML 病例,最初表现为眼球突出和眼眶肿胀,这是由蝶骨和颧骨周围侵袭性的、太阳光线状的骨膜反应引起的。这种独特的表现强调了在儿科患者中,对于太阳光线状骨膜反应,要考虑到白血病浸润的鉴别诊断的重要性。