Abstract:The purpose of this article is to provide a comprehensive review of the imaging features of osseous involvement in haematological malignancies. Osseous involvement can be seen in various haematological malignancies including lymphomas, plasma cell neoplasms, leukaemias and myeloproliferative neoplasms. Imaging plays a crucial role in initial diagnosis, staging and in the assessment of treatment response in these patients.
“…Even though definitive evidence for a direct association between the abnormal MRI findings and the subsequent diagnosis of malignancy was lacking, the slow progression of such disorders, compared with acute leukemias, and the previously described patchy disease distribution of such less aggressive myeloid malignancies in the of the lower limb strongly suggest that this association is plausible. 9 …”
The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.
“…Even though definitive evidence for a direct association between the abnormal MRI findings and the subsequent diagnosis of malignancy was lacking, the slow progression of such disorders, compared with acute leukemias, and the previously described patchy disease distribution of such less aggressive myeloid malignancies in the of the lower limb strongly suggest that this association is plausible. 9 …”
The increasing use of radiological examination, especially magnetic resonance imaging (MRI), will probably increase the risk of unintended discovery of bone marrow abnormalities in patients where a hematologic disease would not be expected. In this paper we present four patients with different hematologic malignancies of nonplasma cell types. In all patients the MRI bone marrow abnormalities represent an initial presentation of the disease. These case reports illustrate the importance of a careful diagnostic follow-up without delay of patients with MRI bone marrow abnormalities, because such abnormalities can represent the first sign of both acute promyelocytic leukemia as well as other variants of acute leukemia.
“…Lymphoma, leukemia, plasma cell myeloma, primary bone neoplasms, and metastatic disease may have either a focal or diffuse distribution in the bone marrow. The spine and pelvis are among the most common bones involved in these conditions ( 141 , 142 ).…”
Axial spondyloarthritis (axSpA) is a chronic inflammatory disorder that predominantly involves the axial skeleton. Imaging findings of axSpA can be divided into active changes, which include bone marrow edema, synovitis, enthesitis, capsulitis, and intra-articular effusion, and structural changes, which include erosions, sclerosis, bone fatty infiltration, fat deposition in an erosion cavity, and bone bridging or ankylosis. The ability to distinguish between imaging lesions suggestive of axSpA and artifacts or lesions suggestive of other disorders is critical for the accurate diagnosis of axSpA. Diagnosis may be challenging, particularly in early-stage disease and magnetic resonance imaging (MRI) plays a key role in the detection of subtle or inflammatory changes. MRI also allows the detection of structural changes in the subchondral bone marrow that are not visible on conventional radiography and is of prognostic and monitoring value. However, bone structural changes are more accurately depicted using computed tomography. Conventional radiography, on the other hand, has limitations, but it is easily accessible and may provide insight on gross changes as well as rule out other pathological features of the axial skeleton. This review outlines the imaging evaluation of axSpA with a focus on imaging mimics and potential pitfalls when assessing the axial skeleton.
“…In a study on 35 patients with WM, FDG-PET/CT positivity was seen in 77% of cases [54]. PET/CT was found to be more sensitive in assessing response to treatment when compared to CT [57]. Fig.…”
Indolent B cell lymphomas are a group of lymphoid malignancies characterized by their potential to undergo histologic transformation to aggressive lymphomas. While different subtypes of indolent B cell lymphomas demonstrate specific clinical and imaging features, histologic transformation can be suspected on cross-sectional imaging when disproportionate lymph node enlargement or new focal lesions in extranodal organs are seen. On PET/CT, transformed indolent lymphoma may show new or increased nodal FDG avidity or new FDG-avid lesions in different organs. In this article, we will (1) review the imaging features of different subtypes of indolent B cell lymphomas, (2) discuss the imaging features of histologic transformation, and (3) propose a diagnostic algorithm for transformed indolent lymphoma. The purpose of this review is to familiarize radiologists with the spectrum of clinical and imaging features of indolent B cell lymphomas and to define the role of imaging in raising concern for transformation and in guiding biopsy for confirmation.
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