Localized relapse in bone marrow of extremities after allogeneic stem cell transplantation for acute lymphoblastic leukemia. 2004

T Endo, and N Sato, and K Koizumi, and M Nishio, and K Fujimoto, and T Sakai, and K Kumano, and M Obara, and K Minauchi, and T Koike
Department of Internal Medicine II, Hokkaido University Graduate School of Medicine, N-15 W-7, Kita-ku, Sapporo 060-8638, Hokkaido, Japan. t-endo@fd5.so-net.ne.jp

We report a patient with a relapsed in bone marrow of extremities after allogeneic peripheral blood stem cell transplantation for acute lymphoblastic leukemia (ALL). The patient complained of pain in the right upper arm and left leg 15 months after transplantation. Magnetic resonance imaging (MRI) and fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) showed abnormal findings in bone marrow of upper and lower extremities. There were no findings of relapse in aspirates from the sternum and iliac bone marrow. Biopsy specimen from the iliac bone marrow showed normocellular marrow without leukemic cells. Biopsy specimen from the right humerus revealed marked leukemic cell infiltration in the bone marrow. This is apparently the first case of localized relapse of ALL in bone marrow of extremities. Physicians should be aware of unusual relapse sites of leukemia after allogeneic stem cell transplantation. MRI and FDG-PET may be of value in detecting this type of relapse.

UI MeSH Term Description Entries
D007085 Ilium The largest of three bones that make up each half of the pelvic girdle. Auricular Surface of Ilium,Iliac Crest,Iliac Crest Bone,Iliac Fossa,Bones, Iliac Crest,Crest Bone, Iliac,Crest Bones, Iliac,Crest, Iliac,Crests, Iliac,Fossa, Iliac,Iliac Crest Bones,Iliac Crests,Iliums
D007867 Leg Bones The bones of the free part of the lower extremity in humans and of any of the four extremities in animals. It includes the PATELLA; TIBIA; and FIBULA. Bones of Leg,Bone, Leg,Bones, Leg,Leg Bone
D008279 Magnetic Resonance Imaging Non-invasive method of demonstrating internal anatomy based on the principle that atomic nuclei in a strong magnetic field absorb pulses of radiofrequency energy and emit them as radiowaves which can be reconstructed into computerized images. The concept includes proton spin tomographic techniques. Chemical Shift Imaging,MR Tomography,MRI Scans,MRI, Functional,Magnetic Resonance Image,Magnetic Resonance Imaging, Functional,Magnetization Transfer Contrast Imaging,NMR Imaging,NMR Tomography,Tomography, NMR,Tomography, Proton Spin,fMRI,Functional Magnetic Resonance Imaging,Imaging, Chemical Shift,Proton Spin Tomography,Spin Echo Imaging,Steady-State Free Precession MRI,Tomography, MR,Zeugmatography,Chemical Shift Imagings,Echo Imaging, Spin,Echo Imagings, Spin,Functional MRI,Functional MRIs,Image, Magnetic Resonance,Imaging, Magnetic Resonance,Imaging, NMR,Imaging, Spin Echo,Imagings, Chemical Shift,Imagings, Spin Echo,MRI Scan,MRIs, Functional,Magnetic Resonance Images,Resonance Image, Magnetic,Scan, MRI,Scans, MRI,Shift Imaging, Chemical,Shift Imagings, Chemical,Spin Echo Imagings,Steady State Free Precession MRI
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D001853 Bone Marrow The soft tissue filling the cavities of bones. Bone marrow exists in two types, yellow and red. Yellow marrow is found in the large cavities of large bones and consists mostly of fat cells and a few primitive blood cells. Red marrow is a hematopoietic tissue and is the site of production of erythrocytes and granular leukocytes. Bone marrow is made up of a framework of connective tissue containing branching fibers with the frame being filled with marrow cells. Marrow,Red Marrow,Yellow Marrow,Marrow, Bone,Marrow, Red,Marrow, Yellow
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006811 Humerus Bone in humans and primates extending from the SHOULDER JOINT to the ELBOW JOINT. Humeri,Greater Tubercle,Humeral Greater Tuberosity,Humeral Lesser Tuberosity,Lesser Tubercle,Olecranon Fossa,Olecranon Fossi,Greater Tubercles,Greater Tuberosities, Humeral,Greater Tuberosity, Humeral,Humeral Greater Tuberosities,Humeral Lesser Tuberosities,Lesser Tubercles,Lesser Tuberosities, Humeral,Lesser Tuberosity, Humeral,Tubercle, Greater,Tubercles, Greater
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001133 Bones of Upper Extremity The bones of the upper and lower ARM. They include the CLAVICLE and SCAPULA. Upper Extremity Bone,Upper Extremity Bones

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