Philadelphia chromosome-positive acute myeloid leukemia with masses and osteolytic lesions： finding of 18F-FDG PET/CT

• Published in: Frontiers of medicine Vol. 11; no. 3; pp. 440 - 444
• Main Authors: Su, Zhan, Wu, Fengyu, Hu, Weiyu, Liu, Xiaodan, Wu, Shaoling, Feng, Xianqi, Cui, Zhongguang, Yang, Jie, Wang, Zhenguang, Guan, Hongzai, Zhao, Hongguo, Wang, Wei, Zhao, Chunting, Peng, Jun
• Format: Journal Article
• Language: English
• Published: Beijing Higher Education Press 01.09.2017; Springer Nature B.V
• Subjects: acute myeloid leukemia; Bone marrow; Bone Marrow - pathology; Case Report; Chromosomes; Fluorodeoxyglucose F18; Humans; Leukemia; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - complications; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - diagnostic imaging; Leukemia, Myelogenous, Chronic, BCR-ABL Positive - pathology; Leukemia, Myeloid, Acute - complications; Leukemia, Myeloid, Acute - diagnostic imaging; Leukemia, Myeloid, Acute - pathology; Male; mass; Medicine; Medicine & Public Health; Middle Aged; osteolysis; Osteolysis - diagnostic imaging; PET; Philadelphia chromosome; positron emission tomography; Positron Emission Tomography Computed Tomography; Soft Tissue Neoplasms - diagnostic imaging; Tomography; 急性; 染色体异常; 病变; 白血病; 费城; 阳性; acute myeloid leukemia; positron emission tomography; osteolysis; mass; Philadelphia chromosome
• ISSN: 2095-0217; 2095-0225
• DOI: 10.1007/s11684-017-0523-x

Philadelphia chromosome-positive acute myeloid leukemia is controversial and difficult to distinguish from the blast phase of chronic myeloid leukemia. As a myeloid neoplasm, rare cases of this leukemia manifest multiple soft-tissue tumors or bone lyric lesions. In this paper, we describe a 49-year-old male patient who had an abrupt onset with sharp chest pain, fever, fatigue, emaciation, and splenomegaly. 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography （18F-FDG PET/CT） result showed diffuse and uneven hypermetabolic lesions in the bone marrow with peripheral bone marrow expansion, multiple soft tissue neoplasms with high 18F-FDG uptake, and lyric bone lesions. Bone marrow smear and biopsy detected aberrant blast cells expressing myeloid rather than lymphoid immunophenotype marker. For the existence of Philadelphia chromosome and BCR-ABL1 fusion gene together with complex chromosome abnormalities, a diagnosis of Philadelphia-positive acute myeloid leukemia was made, although the type （de novo or blast crisis） remained unclear.