A rare case of adult precursor B-cell lymphoblastic lymphoma/leukemia presenting with multiple osteolytic bone lesions as sole manifestation
DOI:
https://doi.org/10.2478/AMB-2023-0044Keywords:
acute lymphoblastic lymphoma/leukemia, bone lesions, PET/CTAbstract
Primary precursor B-lymphoblastic lymphoma/leukemia (B-LBLL) of bone is uncommon neoplasm that accounts for less than 1% of primary bone tumors. It has been commonly reported in pediatric population but is rare in adults. We present a case of a 20-year-old man with multiple osteolytic lesions as sole presentation of acute lymphoblastic leukemia, whose diagnosis was established by bone biopsy. A peripheral blood smear and the bone marrow aspirate showed no blast cells. The patient received treatment according to BFM 99 protocol and achieved complete response confirmed by F-FDG-PET/CT.
References
Terwilliger T, Abdul-Hay M. Acute lymphoblastic leukemia: a comprehensive review and 2017 update. Blood Cancer J. 2017 Jun 30;7(6):e577. doi: 10.1038/bcj.2017.53.
Sinigaglia R, Gigante C, Bisinella G, et al. Musculoskeletal manifestations in pediatric acute leukemia. J Pediatr Orthop 2008;28:20–8. 10.1097/BPO.0b13e31815ff 350
El-Ashwah S, Eisa N, Denewer M, et al. Hypercalcemia With Disseminated Osteolytic Lesions: A Rare Presentation of Adulthood Acute Lymphoblastic Leukemia. J Hematol. 2018 Dec;7(4):154-157. doi: 10.14740/jh455w.
Kaiafa G, Perifanis V, Kakaletsis N, et al. Hypercalcemia and multiple osteolytic lesions in an adult patient with relapsed pre-B acute lymphoblastic leukemia: a case report. Hippokratia. 2015;19(1):78-81.
Muler JH, Valdez R, Hayes C, et al. Acute megakaryocytic leukemia presenting as hypercalcemia with skeletal lytic lesions. Eur J Haematol. 2002;68:392-396.
Kwong YL, Ng I, Leung S. Osteolytic skeletal lesions in chronic myeloid leukemia. Pathology. 1990;22:123-125.
Rossi J, Bataille R, Chappard D, et al. B cell malignancies presenting with unusual bone involvement and mimicking multiple myeloma. Am J Med. 1987;83:10-16.
Chung SW, Kim S, Choi JR, et al. Osteolytic mandible presenting as an initial manifestation of an adult acute lymphoblastic leukaemia. Int J Oral Maxillofac Surg. 2011;40(12):1438-40.
Fukasawa H, Kato A, Fujigaki Y, et al. Hypercalcemia in a patient with B-cell acute lymphoblastic leukemia: a role of proinflammatory cytokine. Am J Med Sci. 2001;322(2):109-12.
Seymour JF, Kantarjian HM. Hypercalcemia in acute lymphoblastic leukemia. Leuk Res. 1994;18(3):231-2.
Verma SP, Dubashi B, Basu D, et al. A rare case of adult acute lymphoblastic leukemia presenting with paraparesis and multiple osteolytic lesions. Indian J Hematol Blood Transfus. 2014;30(Suppl 1):24-6.
Granacher NCP, Berneman ZN, Schroyens W et al. Adult acute precursor B-cell lymphoblastic leukemia presenting as hypercalcemia and osteolytic bone lesions. Exp Hematol Oncol, 2017, 6, 9.
Heinrich SD, Gallagher D, Warrior,R, et al. The prognostic signifi cance of the skeletal manifestations of acute lymphoblastic leukemia of childhood. J Pediatr Orthop 1994;14:105-11.
Mathur M, Sykes JA, Saxena VR, et al. Treatment of acute lymphoblastic leukemia-induced extreme hypercalcemia with pamidronate and calcitonin. Pediatr Crit Care Med. 2003; 4: 252-55.
Abbas AAH, Husain AH, Abdelaal MA, et al. Acute lymphoblastic leukemia presenting with extensive skeletal lesions and bone marrow necrosis. Med Pediatr Oncol. 2001; 37: 64-6.
Lee Y, Lim YJ, Bae JJ, et al. Hypercalcemia and extensive osteolytic lesion with increased plasma prostaglandin E2 level in a child with acute lymphoblastic leukemia. Korean J Hematol. 2007; 42(4): 433-8.
Peterson K, Higgins R, Peterson T et al. Osteolytic bone lesions, hypercalcemia, and renal failure: a rare presentation of childhood acute lymphoblastic leukemia. AJCC-REP, 2013, 1(2).
Inukai T, Hirosh K, Inaba T et al. Hypercalcemia in childhood acute lymphoblastic leukemia: frequent implication of parathyroid hormone-related peptide and E2A-HLF from translocation 17;19 Leukemia 2007, 21.
Shimonodan H, Nagayama J and Nagatoshi Y. Acute lymphocytic leukemia in adolescence with multiple osteolytic lesions and hypercalcemia mediated by lymphoblast-producing parathyroid hormone-related peptide: a case report and review of the literature Pediatr Blood Cancer, 2005, 45(3).
Lin P, Jones D, Dorfman DM, et al. Precursor B-cell Lymphoblastic Lymphoma. A Predominantly Extranodal Tumor With Low Propensity for Leukemic Involvement. Am J Surg Pathol 2000; 24(11): 1480-1490.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
You are free to share, copy and redistribute the material in any medium or format under these terms.
Journal Acta Medica Bulgarica 
