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November 1959

Acute Leukemia: Skeletal Manifestations in Children and Adults

Author Affiliations

Bethesda, Md.

Diagnostic X-Ray Department, Clinical Center (Drs. Hilbish, Besse, Lusted, and Daves); Department of Pathological Anatomy, Clinical Center (Dr. Thomas), and Chemotherapy Section (Dr. Forkner), National Cancer Institute.

AMA Arch Intern Med. 1959;104(5):741-747. doi:10.1001/archinte.1959.00270110061007

This exhibit demonstrates the bony changes resulting from acute leukemia, with direct correlation between roentgen findings and histological abnormalities. In adults the primary lesions are those of osteoporosis and lytic destruction of the cortices and medullary cavities. In children the most conspicuous changes occur in the metaphyses of the long bones and consist of radiolucent bands of decreased density associated, at times, with areas of bony destruction. Cortical thinning, periosteal new bone formation, infiltration, and hemorrhage, as well as lytic lesions of the medullary cavities and cortices, are observed. Growth lines are often demonstrated in those patients experiencing periods of remission following antileukemic therapy.

The radiolucent bands at the metaphyses and along the borders of vertebral bodies have been attributed to leukemic infiltration. The exact explanation for these zones of decreased density was not apparent from this study. Histologically, the trabeculae in these radiolucent areas were decreased in size and

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