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Chronic myeloid leukemia (MRI)

Case contributed by Ali Nourian
Diagnosis almost certain

Presentation

Low back pain

Patient Data

Age: 70 years
Gender: Male

The signal intensity of bone marrow is abnormally diffusely hypointense, compatible with an infiltrative bone marrow disease. Also note marked splenomegaly.

Case Discussion

In this case, the patient was a known case of chronic myeloid leukemia. Diffuse homogeneous signal abnormalities can easily be missed and assessment of marrow should always be a review area.

Normal bone marrow is always slightly hyperintense to muscle and disc (due to scattered fat cells). In this case the signal intensity of bone marrow is abnormally diffusely hypointense, compatible with an infiltrative bone marrow disease. 

Differential diagnosis:

  • myeloproliferative and lymphoproliferative diseases
  • diffuse skeletal metastasis 
  • iron deposition related pathologies, e.g. hemochromatosis

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