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Unusual presentation of more common disease/injury
CASE REPORT
Acute lymphoblastic leukaemia with osteolytic bone lesions: diagnostic dilemma
  1. Natthapon Angsubhakorn1,
  2. Attaya Suvannasankha2
  1. 1Department of Medicine, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota, USA
  2. 2Division of Hematology/Oncology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
  1. Correspondence to Dr Attaya Suvannasankha, asuvanna{at}iupui.edu

Summary

A previously healthy 37-year-old man presented with a 10-month history of intractable back pain. On examination, there was tenderness to palpation along lower thoracic and lumbar spine. Complete blood count showed mild anaemia but was otherwise unremarkable. Imaging studies revealed compression deformities with multiple osteolytic lesions involving multiple levels of the thoracic and lumbar spine. Bone marrow aspiration and biopsy were performed and demonstrated blast cells involving 80% of the bone marrow cellularity. Findings on flow cytometry were consistent with B-lymphoblastic leukaemia. He was subsequently started on hyper-CVAD (fractionated cyclophosphamide, vincristine, Adriamycin and dexamethasone) induction chemotherapy.

  • malignant and benign haematology
  • chemotherapy
  • calcium and bone

https://doi.org/10.1136/bcr-2018-225008

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    Footnotes

    • Contributors Both NA and AS cared for the patient during his hospitalisation. After the decision to write up the case report, NA gathered and summarised the patient’s clinical information. NA and AS reviewed and summarised the data from previously published cases, and together drafted the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.