Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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MRI Finding of a Case of Relapsed Acute Mixed Type Leukemia with Bone Marrow Necrosis

재발한 급성 혼합형 백혈병에 동반된 골수괴사 1례의 MRI 소견

  • Park, Joo Young (Department of Pediatrics, College of Medicine, Keimyung University) ;
  • Park, Euk (Department of Pediatrics, College of Medicine, Keimyung University) ;
  • Park, Seat Byeoul (Department of Pediatrics, College of Medicine, Keimyung University) ;
  • Jeon, Dong Seok (Department of Clinical Pathology, College of Medicine, Keimyung University) ;
  • Lee, Hee Jung (Department of Diagnostic Radiology, College of Medicine, Keimyung University) ;
  • Kim, Heung Sik (Department of Pediatrics, College of Medicine, Keimyung University) ;
  • Kang, Chin Moo (Department of Pediatrics, College of Medicine, Keimyung University)
  • 박주영 (계명대학교 의과대학 소아과학교실) ;
  • 박억 (계명대학교 의과대학 소아과학교실) ;
  • 박샛별 (계명대학교 의과대학 소아과학교실) ;
  • 전동석 (계명대학교 의과대학 임상병리학교) ;
  • 이희정 (계명대학교 의과대학 진단방사선학교) ;
  • 김흥식 (계명대학교 의과대학 소아과학교실) ;
  • 강진무 (계명대학교 의과대학 소아과학교실)
  • Received : 2001.08.13
  • Accepted : 2001.09.29
  • Published : 2002.02.15
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Abstract

Bone marrow necrosis is a rare complication of a variety of diseases affecting the marrow. The cause and incidence are unknown, and reports of treatment response are rare. We describe a case of relapsed acute mixed type leukemia with bone marrow necrosis. The patient was a 10 year old female diagnosed with acute mixed type leukemia four years ago. She had been on second remission state for 1 year, presented with severe back pain, tenderness in lower extremities, low-grade fever and general weakness. Her level of serum lactic dehydrogenase on admission was increased. Bone marrow aspiration from both posterior iliac crest showed marrow necrosis. Subsequent examination showed the same feature. Hip MRI showed heterogenous low signal intensity in both iliac bone on T-1 weighted image and heterogenous high signal intensity on T-2 wieghted image. Remission induction therapy was started but she expired on 59th hospital day due to the complication of sepsis.

골수괴사는 골수를 침범하는 매우 드문 조직 소견으로 저자들은 급성 혼합형 백혈병 환아가 요통, 발열을 주소로 방문하여 세번째 재발하였을 때 골수 천자 도말 검사에서 골수괴사가 동반되고 혈청 LDH와 ferritin이 증가되었으며 자기공명영상에서 골수괴사의 특징적인 소견을 보인 1례를 경험하였기에 보고하는 바이다.

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