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Chronic myeloid leukemia

Case contributed by Chris O'Donnell
Diagnosis almost certain

Presentation

Low back pain.

Patient Data

Age: 85 years
Gender: Male
mri

Bone marrow is diffusely of dark signal on T1 and high on STIR, apart from the Modic type II changes in the L5/S1 endplates. This indicates conversion or infiltration of normal yellow (fatty) marrow. 

Spleen is markedly enlarged.

Case Discussion

Always look at the vertebral body signal on MRI scanning of the spine as it may be the first clue to bone marrow pathology. Review of medical history, in this case, confirmed that the patient had CML for many years. The spleen is markedly enlarged, as occurs in CML.

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