Journal articles: 'Bone marrow lesions'

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Belurkar, Sushma, Anna Joseph Amprayil, and Chethan Manohar. "Clinicopathologic Study of Granulomatous Lesions in the Bone Marrow." Indian Journal of Forensic Medicine and Pathology 11, no. 3 (2018): 192–201. http://dx.doi.org/10.21088/ijfmp.0974.3383.11318.8.

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Erik Jensen, Karl. "DETECTION OF BONE MARROW LESIONS." Lancet 333, no. 8642 (April 1989): 843–44. http://dx.doi.org/10.1016/s0140-6736(89)92299-x.

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Björkman, Ann-Sofi, Seppo K. Koskinen, Maria Lindblom, and Anders Persson. "Diagnostic accuracy of dual-energy CT for detection of bone marrow lesions in the subacutely injured knee with MRI as reference method." Acta Radiologica 61, no. 6 (October 3, 2019): 749–59. http://dx.doi.org/10.1177/0284185119877343.

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Background Dual-energy computer tomography (DECT) can detect post-traumatic bone marrow lesions. Prospective studies of the knee with large numbers of participants and intra-observer agreement assessment are limited. Purpose To investigate the diagnostic accuracy of DECT in detecting bone marrow lesions as well as estimating the bone marrow lesion volume in patients with suspected anterior cruciate ligament trauma with magnetic resonance imaging (MRI) as reference standard. Material and Methods Forty-eight consecutive patients with suspected anterior cruciate ligament injury were imaged bilaterally with DECT within a mean of 25 days (range 4–55 days) following injury and MRI within seven days of DECT. Two readers analyzed DECT virtual non-calcium-blinded images. Consensus MRI was reference standard. Intra- and inter-observer agreement were determined using weighted kappa statistics. Sensitivity, specificity, and negative and positive predictive values were calculated. Bone marrow lesion volumes were measured; for comparison, intra-class correlation coefficient was used. Results The 48 patients (26 men, 22 women; mean age 23 years, age range 15–37 years) were imaged bilaterally yielding 52 knees with bone marrow lesions, of which 44 were in the femur and 41 were in the tibia. Intra- and inter-observer agreement to detect bone marrow lesions was moderate and fair to moderate (κ 0.54–0.66, 95% confidence interval [CI] 0.39–0.80 and 0.37–0.41, 95% CI 0.20–0.57) and overall sensitivity and specificity were 70.1% and 69.1%, respectively. Positive and negative predictive values were 72.9% and 66.1%, respectively. Bone marrow lesion volumes showed excellent intra- and inter-observer agreement (0.83–0.91, 95% CI 0.74–0.94 and 0.76–0.78, 95% CI 0.57–0.87). Conclusion The diagnostic performance of DECT to detect bone marrow lesions in the subacutely injured knee was moderate with intra- and inter-observer agreement ranging from moderate to substantial and fair to moderate. Bone marrow lesion volume correlation was excellent.

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Lutsik, N. S., L. P. Mendeleeva, and G. A. Yatsik. "Informative value of whole-body magnetic resonance imaging with diffusion-weighted images for the detection of bone marrow infiltration in patients with multiple myeloma (literature review)." Oncohematology 17, no. 1 (January 29, 2022): 87–94. http://dx.doi.org/10.17650/1818-8346-2022-17-1-87-94.

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Magnetic resonance imaging (MRI) is increasingly being used to diagnose bone marrow lesions in patients with multiple myeloma (MM). Since 2014, the results of MRI have been included in the updated criteria of the International Myeloma Working Group. The presence of >1 bone marrow lesion larger than or equal to 5 mm on MRI is considered sufficient for the diagnosis of symptomatic MM, requiring initiation of treatment. MRI assessment of bone marrow is also possible with functional sequences such as diffusion-weighted imaging (DWI), which provide additional information about the bone marrow. This article provides an overview of the possibilities of MRI with anatomical sequences and with DWI for diagnosing, monitoring and evaluating the response to treatment in patients with MM. In patients with monoclonal gammopathy of undetermined significance and smoldering myeloma, in some cases, pathological changes in the bone marrow can be detected by MRI. The presence of >1 bone marrow lesion on MRI is a cut-off value as a prognostic factor for the progression of monoclonal gammopathy of undetermined significance or smoldering myeloma to symptomatic MM. In symptomatic MM, there are four patterns of bone marrow infiltration on MRI – focal, diffuse, “salt-and-pepper” infiltration, and combined diffuse and focal pattern, which have prognostic significance. Patients with diffuse pattern of infiltration on MRI had a 3-year overall survival of 35 % versus 92 % in patients with normal MRI bone marrow. During treatment of MM patients, residual bone marrow lesions are often identified on MRI. MRI residual bone marrow lesions increase the risk of MM relapse. In the group of patients who had residual bone marrow lesions on MRI on the 100th day after autologous hematopoietic stem cell transplant, 2-year progression-free survival was 50 % versus 89 % in patients without bone marrow lesions at the same time. The addition of DWI to the scan protocol helps to differentiate persistent focal bone marrow lesions that can lead to MM relapse after the treatment phase. Apparent diffusion coefficient is a quantitative indicator of DWI. MRI can serve as a valuable tool for assessing the treatment response in patients with MM.

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Nazinkina, Yu V. "BONE MARROW LESIONS: DIAGNOSIS WITHOUT BIOPSY." Diagnostic radiology and radiotherapy, no. 1 (April 9, 2019): 19–25. http://dx.doi.org/10.22328/2079-5343-2019-10-1-19-25.

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Routine spinal MRI can be used for bone marrow lesions detection. The most useful standard pulse sequence is T1- WI, which helps both in local and diffuse bone marrow diseases. Additional new pulse sequences, including chemical shift imaging and diffusion weighted imaging, can be used as solving-problem techniques.

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Sharkey, Peter, and Steven Cohen. "Subchondroplasty for Treating Bone Marrow Lesions." Journal of Knee Surgery 29, no. 07 (December 7, 2015): 555–63. http://dx.doi.org/10.1055/s-0035-1568988.

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Chang, Karen L., Karl K. Gaal, Qin Huang, and Lawrence M. Weiss. "Histiocytic lesions involving the bone marrow." Seminars in Diagnostic Pathology 20, no. 3 (August 2003): 226–36. http://dx.doi.org/10.1016/s0740-2570(03)00030-3.

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ZOLER, MITCHEL L. "Zoledronic Acid Shrank Bone Marrow Lesions." Family Practice News 41, no. 11 (June 2011): 17. http://dx.doi.org/10.1016/s0300-7073(11)70583-7.

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ZOLER, MITCHEL L. "Zoledronic Acid Shrinks Bone Marrow Lesions." Internal Medicine News 44, no. 12 (July 2011): 24–25. http://dx.doi.org/10.1016/s1097-8690(11)70601-1.

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Hyun, Bong Hak. "Plasmacytic lesions of the bone marrow." International Journal of Hematology 76, S2 (March 2002): 11. http://dx.doi.org/10.1007/bf03165079.

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ZOLER, MITCHEL L. "Zoledronic Acid Shrinks Bone Marrow Lesions." Clinical Endocrinology News 6, no. 6 (June 2011): 28–29. http://dx.doi.org/10.1016/s1558-0164(11)70275-9.

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Ågren, B., B. Löqvist, B. Björkstrand, U. Rudberg, and P. Aspelin. "Radiography and bone scintigraphy in bone marrow transplant multiple myeloma patients." Acta Radiologica 38, no. 1 (January 1997): 144–50. http://dx.doi.org/10.1080/02841859709171259.

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Purpose: To compare conventional radiography and bone scintigraphy in relation to clinical outcome in bone marrow transplant multiple myeloma patients. Material and Methods: A total of 70 radiographies and 70 bone scintigraphies were compared in 35 patients. Results: The skull, the extremities, the iliac and pubic bones were better assessed with radiography. For new vertebral lesions and for lesions in the ribs and sternum, bone scintigraphy proved superior. For the sacrum, the methods were equal. When bone scintigraphy was used as a complement to radiography, 4% more pathological sites were found. No patient had both a normal radiography and a pathological bone scintigraphy, but 5 patients had both a normal bone scintigraphy and a pathological radiography. The results of the radiological examinations did not always correlate with the clinician's grading of the patient's disease. The radiological examinations had no prognostic value for the 7 patients examined on several occasions. Conclusion: The ability of conventional radiography and bone scintigraphy to disclose myeloma lesions varies, depending on location and size of the lesions. Radiography should remain the primary examination modality also for bone marrow transplant multiple myeloma patients. Bone scintigrapy can serve as a complement for investigating unexplained pain, e.g. caused by lesions in vertebrae or ribs.

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Ågren, B., U. Rudberg, and P. Aspelin. "Dynamic Scintigraphy of Bone and Bone Marrow in Multiple Myeloma Patients with Bone-Marrow Transplants." Acta Radiologica 38, no. 4 (July 1997): 533–38. http://dx.doi.org/10.1080/02841859709174382.

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Purpose: To determine whether dynamic registration at bone and bone-marrow scintigraphy produces additional information compared to subsequent static registrations of bone-marrow transplants in multiple myeloma patients. Material and Methods: In a prospective study, 8 dynamic bone and 6 dynamic bone-marrow scintigraphies were performed in 10 patients. The dynamic scintigraphies were compared with conventional radiography, MR images, and static scintigraphies of bone and bone marrow. Results: No additional information was revealed by the dynamic registration method; on the contrary, 4 of the 8 known lesions were not discerned at dynamic registration. An incidental observation was that the time-activity curves of both radiopharmaceuticals had a specific pattern. Conclusion: Dynamic registration at bone and bone-marrow scintigraphy was not useful for detecting disease in multiple myeloma lesions.

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Kim, Seung Jae J., Yusuhn Kang, Dae Ha Kim, Jae Young Lim, Joo Hyun Park, and Joo Han Oh. "Focal Bone Marrow Lesions: A Complication of Ultrasound Diathermy." Clinics in Shoulder and Elbow 22, no. 1 (March 1, 2019): 40–45. http://dx.doi.org/10.5397/cise.2019.22.1.40.

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Ultrasound diathermy is widely used for the treatment of musculoskeletal disorders and other soft tissue injuries. Its use as a therapeutic modality is believed to be safe, with very few reported complications. Here, we report two patients who developed focal bone marrow abnormalities after receiving ultrasound diathermy. Both patients’ magnetic resonance (MR) evaluations revealed linear subchondral bone lesions of the superolateral humeral head similar to those in osteonecrosis. The patients’ symptoms subsequently improved, and available follow-up MR evaluation revealed near complete resolution of bone lesions. These findings suggest that ultrasound diathermy, and its interaction with bone tissue through thermal mechanisms, can cause focal bone marrow abnormalities. Furthermore, the bone marrow abnormalities seem to be transient, resolving upon cessation of ultrasound diathermy, therefore osteonecrosis should be differentiated from this temporal lesion.

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Eriksen, Erik Fink, and Johan Diederich Ringe. "Bone marrow lesions: a universal bone response to injury?" Rheumatology International 32, no. 3 (September 8, 2011): 575–84. http://dx.doi.org/10.1007/s00296-011-2141-2.

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Momo, Claudia, Ana Paula Prudente Jacintho, Pamela Rodrigues Reina Moreira, Danísio Prado Munari, Gisele Fabrino Machado, and Rosemeri de Oliveira Vasconcelos. "Morphological Changes in the Bone Marrow of the Dogs with Visceral Leishmaniasis." Veterinary Medicine International 2014 (2014): 1–5. http://dx.doi.org/10.1155/2014/150582.

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The aim of this study was to evaluate the most frequent lesions in the bone marrow of dogs naturally infected byLeishmania (Leishmania) chagasi.Thirty-three dogs sacrificed at the Zoonosis Control Center of Araçatuba, a municipality endemic for visceral leishmaniasis (VL), were used. The animals were classified as asymptomatic, oligosymptomatic, and symptomatic groups. At the necropsy, bone marrow samples were collected from the femur, fixed, processed, and stained with hematoxylin and eosin. The lesion intensity was classified as mild, moderate, or severe. The parasite load was determined using immunohistochemistry. The most important lesions consisted of multifocal to diffuse granulomas, megakaryocytic dysplasia, and medullary aplasia. There were no statistical differences between the three clinical groups regarding parasite load and lesion intensity. Asymptomatic dogs also presented high parasitism in the bone marrow as dogs with clinical signs of VL. It was concluded that, regardless of clinical group, the bone marrow is a site for multiplication ofLeishmania chagasi. Possibly, the bone marrow dysplasia may arise from the presence of many parasitized and activated macrophages in this organ. Consequently, it affects the profile of hematopoietic cells in the bone marrow and systemic circulation.

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Murawski, Christopher D., Li Foong Foo, and John G. Kennedy. "A Review of Arthroscopic Bone Marrow Stimulation Techniques of the Talus." CARTILAGE 1, no. 2 (March 29, 2010): 137–44. http://dx.doi.org/10.1177/1947603510364403.

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Osteochondral lesions of the talus are common injuries following acute and chronic ankle sprains. Numerous surgical treatment strategies have been employed for treating these lesions; arthroscopic bone marrow stimulation is recognized as the first-line technique to provide fibrocartilage infill of the defect site. While the short- and medium-term outcomes of this technique are good, the long-term outcomes are not yet known. An increasing number of studies, however, show a cause for concern in employing this technique, including declining outcome scores over time. The current authors have therefore developed a treatment strategy based on previously established guidelines in addition to morphological cartilage-sensitive fast spin echo techniques and quantitative T2 mapping magnetic resonance imaging (MRI). Accordingly, the authors advocate arthroscopic bone marrow stimulation in lesion sizes up to 8 mm in diameter and osteochondral autograft transplant (OATS) in lesion sizes greater than 8 mm in diameter. In the absence of long-term studies, confining the use of arthroscopic bone marrow stimulation to smaller lesions may support prolonged joint life by decreasing the rate at which the fibrocartilage ultimately degenerates over time. Employing the OATS procedure in larger lesions has the advantage of replacing “like with like.” The current review examines the role of arthroscopic bone marrow stimulation techniques of the talus.

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Cora, Michelle C., Kyathanahalli S. Janardhan, Heather Jensen, Natasha Clayton, and Gregory S. Travlos. "Previously Diagnosed Reticulum Cell Hyperplasia in Decalcified Rat Bone Marrow Stain Positive for Ionized Calcium Binding Adapter Molecule 1 (Iba1): A Monocytic/Macrophage Cell Marker." Toxicologic Pathology 48, no. 2 (December 5, 2019): 317–22. http://dx.doi.org/10.1177/0192623319890610.

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Reticulum cell hyperplasia (RCH) was a term used for many years by the National Toxicology Program (NTP) to describe a certain non-neoplastic bone marrow lesion of rats. Retrospective microscopic evaluation of RCH lesions and immunohistochemistry analyses were performed to reassess and further characterize these lesions. The NTP database was searched to identify femoral bone marrow specimens diagnosed with RCH from 1981 to 2014 (n = 254). The diagnosis last occurred in 2003, after which the term “cellular infiltration” was used. Eighty-three RCH slides, spanning 22 years, representing 34 different chemicals, were selected for microscopic review, and a subset (23) was chosen for ionized calcium binding adapter molecule 1 (Iba1) immunohistochemical staining; initial investigations revealed Iba1 worked as a macrophage marker on decalcified tissue. The following diagnoses were made upon reevaluation: 36 were consistent with cellularity increased, macrophage, 22 with histiocytic sarcoma, 8 with increased myeloid cells, 4 with autolysis, and 13 were normal appearance. All 23 RCH lesions stained positive for Iba1. Fifty-eight of 83 bone marrows previously diagnosed with RCH are consistent morphologically and immunohistochemically with cells of histiocytic origin. These results will help with interpretation of historical data and demonstrates that Iba1 can be used in decalcified bone marrow sections.

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d'Anjou, M.-A., J. Cabassu, N. Chailleux, L. Blond, and J. Olive. "Fast presurgical magnetic resonance imaging of meniscal tears and concurrent subchondral bone marrow lesions." Veterinary and Comparative Orthopaedics and Traumatology 27, no. 01 (2014): 01–07. http://dx.doi.org/10.3415/vcot-13-04-0054.

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SummaryMeniscal tears and subchondral bone marrow lesions have both been described in dogs with cranial cruciate ligament rupture, but their possible concurrence has not been evaluated. In a population of 14 dogs exhibiting signs of stifle pain with surgically confirmed cranial cruciate ligament rupture, a short presurgical 1.5T magnetic resonance (MR) imaging protocol including dorsal proton density, dorsal T1-weighted gradient recalled echo, and sagittal fat-saturated dual echo sequences was tested to further investigate these features and illustrate meniscal tears. Interobserver agreement for detection of medial meniscal tears (k = 0.83) and bone marrow lesions (k = 0.87) was excellent. Consensus MR reading allowed detection of nine out of 12 surgically confirmed medial meniscal tears and there was no false positive. All dogs had cruciate ligament enthesisrelated bone marrow lesions in the tibia, femur or both bones. Additionally, among the 12 dogs with confirmed medial meniscal tears, subchondral bone marrow lesions were present in the caudomedial (9 dogs) and caudoaxial (11 dogs) regions of the tibial plateau, resulting in odds ratios (13.6, p = 0.12, and 38.3, p = 0.04, respectively) that had large confidence intervals due to the small group size of this study. The other two dogs had neither tibial bone marrow lesions in these locations nor medial meniscal tears. These encouraging preliminary results warrant further investigation using this clinically realistic preoperative MR protocol. As direct diagnosis of meniscal tears remained challenging in dogs even with high-field MR, identification of associated signs such as subchondral bone marrow lesions might indirectly allow suspicion of an otherwise unrecognized meniscal tear.

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Chhabra, Avneesh, FilippoDel Grande, SaharJ Farahani, and JohnA Carrino. "Bone marrow lesions: A systematic diagnostic approach." Indian Journal of Radiology and Imaging 24, no. 3 (2014): 279. http://dx.doi.org/10.4103/0971-3026.137049.

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KOBAYASHI, Satoshi, and Yasuni NAKANUMA. "Hepatic venous lesions following bone marrow transplantation." Kanzo 33, no. 9 (1992): 699–704. http://dx.doi.org/10.2957/kanzo.33.699.

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Hussain, Akhlak, Mohinder Singh, Kuldip Singh, and Harjot Bagga. "Multiple Extramedullary Plasmacytoma with Lytic Bony Lesions: A Rare Case Report." Case Reports in Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/291359.

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Objective. Multiple extramedullary plasmacytoma lesions involving subcutaneous tissue, breast, mediastinal tissue, spleen, and soft tissue of pelvic region along with multiple bones plasmacytomas without marrow plasmacytosis are a very rare presentation.Design. Case report.Result. A 54-year-old female was found to have multiple small bony lytic lesions, multiple extramedullary soft tissue plasmacytomas, serum M protein >3 g/dL, and elevated ESR. Bone marrow aspirate did not reveal any evidence of multiple myeloma/plasmacytosis. There was no anemia, hypercalcemia, or renal insufficiency.Conclusion. Extramedullary plasmacytoma can involve multiple organs at a time including bones and soft tissue without involving bone marrow.

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Reinhardt, M., E. Nitzsche, E. Moser, and Th Krause. "Photopenic Lesions in Bone Marrow Scintigraphy Using Technetium-99m Labeled Antigranulocyte Antibody without Known Tumour." Nuklearmedizin 38, no. 03 (1999): 85–89. http://dx.doi.org/10.1055/s-0038-1632197.

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Summary Aim: The purpose of this study was to elucidate the frequency of photopenic lesions in patients without known tumour disease by using bone marrow scintigraphy with Tc-99m labeled anti-NCA-95. Methods: Whole body immunoscintigraphy (IS) was performed in 141 consecutive patients with fever of unknown origin. The age ranged between 20 and 88 years with a mean age of 57 years. None of the patients had known tumour disease. Scans were evaluated with respect to photopenic lesions and to bone marrow distribution. Results: IS showed bone marrow defects in the axial skeleton in 16 patients (11 %). With the help of the typical scintigraphic defect pattern, the cause of the lesions was clearly identified as degenerative changes in four patients and in one patient as due to prior sternotomy. In the remaining 11 patients the origin of the defects became evident when the case history or additional imaging was consulted. The mean age of these 16 patients was 69 years ranging from 50 to 88 years. There was an age-related frequency of defects. 10% of the patients from 50 to 59 years showed defects, 60-69 years 9%, 70-79 years 30%, and 33% of the patients from 80 to 89 years had defects. IS was not hampered by tracer uptake to liver or spleen in 93 patients. Left caudal ribs were obscured in 48 patients with intense tracer uptake to the spleen. No or markedly reduced tracer uptake was found in caput humeri and caput femori in 94 and 82 patients, respectively. Patchy tracer uptake to the bone marrow of the limbs was seen in 13/62 patients showing marrow expansion in the lower limbs and 14/55 with marrow expansion in the upper limbs. The patchy pattern was asymmetric in 12 of these patients. Conclusion: The results of the present study reveal that using Tc-99m NCA-95, photopenic lesions of the bone marrow are rarely seen in patients without known malignant disease. The occurrence of benign lesions is age-related. The benign cause of the lesion was obvious from location and pattern of the lesion in about 30% of the cases. Evaluation of lesions in the upper and lower limbs may be hindered due to physiological variation of marrow distribution. Nevertheless, IS appears to be well-suited for the detection and localization of bone marrow metastases.

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Kon, Elizaveta, Mario Ronga, Giuseppe Filardo, Jack Farr, Henning Madry, Giuseppe Milano, Luca Andriolo, and Nogah Shabshin. "Bone marrow lesions and subchondral bone pathology of the knee." Knee Surgery, Sports Traumatology, Arthroscopy 24, no. 6 (April 13, 2016): 1797–814. http://dx.doi.org/10.1007/s00167-016-4113-2.

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James, S. L. J., R. J. Hughes, K. E. Ali, and A. Saifuddin. "MRI of bone marrow oedema associated with focal bone lesions." Clinical Radiology 61, no. 12 (December 2006): 1003–9. http://dx.doi.org/10.1016/j.crad.2006.07.007.

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Raissaki, Maria, Stelios Demetriou, Konstantinos Spanakis, Christos Skiadas, Nikolaos Katzilakis, Emmanouil G. Velivassakis, Eftichia Stiakaki, and Apostolos H. Karantanas. "Multifocal bone and bone marrow lesions in children — MRI findings." Pediatric Radiology 47, no. 3 (December 21, 2016): 342–60. http://dx.doi.org/10.1007/s00247-016-3737-1.

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Candela, Vincenzo, Umile Giuseppe Longo, Mauro Ciuffreda, Giuseppe Salvatore, Alessandra Berton, Matteo Cimmino, and Vincenzo Denaro. "Talar osteochondral size influences outcome after bone marrow stimulation: a systematic review." Journal of ISAKOS: Joint Disorders & Orthopaedic Sports Medicine 2, no. 6 (October 27, 2017): 318–24. http://dx.doi.org/10.1136/jisakos-2016-000092.

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ImportanceNo accepted definition of lesion size exists to treat osteochondral defects (OCD) of talus with bone marrow stimulation.ObjectiveThe aim of this study is to establish a relationship between the clinical outcomes and size of OCD lesion to identify the area or diameter best suited to be treated with arthroscopic bone marrow stimulation.Evidence reviewA search was conducted of level I through IV studies from January 2000 to August 2017, to identify studies reporting on talus OCDs treated with bone marrow stimulation. 21 articles were identified. The overall quality of evidence was fair.Findings21 articles were included in which 1303 ankles with OCD of talus were evaluated. Patients were assessed at a median follow-up period of 38.1 months, ranging from 6.3 to 217 months. Considering a cut-off of an area <1.5 cm2 or with a diameter ≤1.5 cm, the mean postoperative AOFAS (American Orthopaedic Foot and Ankle Society) value was 89.1±3 and 84.65±2.7, respectively (p=0.016).Conclusions and relevanceDespite the current lack of high-level evidence, our results suggest that bone marrow stimulation techniques provide an effective and reliable means to treat small to mid-sized OCD. Arthroscopic bone marrow stimulation for isolated osteochondral lesions of the talus is a safe and effective procedure that provides good clinical outcomes for lesions with an area less than 1.5 cm2 or with a diameter less than 1.5 cm. The attempt to find a new cut-off value to identify more precisely good outcome lesions was unsuccessful. However, the long-term benefits of bone marrow stimulation techniques should be tested in larger cohort of patients with longer term evaluations.Level of evidenceSystematic review, level III.

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van Vucht, Niels, Rodney Santiago, Ian Pressney, and Asif Saifuddin. "Role of in-phase and out-of-phase chemical shift MRI in differentiation of non-neoplastic versus neoplastic benign and malignant marrow lesions." British Journal of Radiology 94, no. 1119 (March 1, 2021): 20200710. http://dx.doi.org/10.1259/bjr.20200710.

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Objective: To determine its ability of in-phase (IP) and out-of-phase (OOP) chemical shift imaging (CSI) to distinguish non-neoplastic marrow lesions, benign bone tumours and malignant bone tumours. Methods: CSI was introduced into our musculoskeletal tumour protocol in May 2018 to aid in characterisation of suspected bone tumours. The % signal intensity (SI) drop between IP and OOP sequences was calculated and compared to the final lesion diagnosis, which was classified as non-neoplastic (NN), benign neoplastic (BN) or malignant neoplastic (MN). Results: The study included 174 patients (84 males; 90 females: mean age 44.2 years, range 2–87 years). Based on either imaging features (n = 105) or histology (n = 69), 44 lesions (25.3%) were classified as NN, 66 (37.9%) as BN and 64 (36.8%) as MN. Mean % SI drop on OOP for NN lesions was 36.6%, for BN 3.19% and for MN 3.24% (p < 0.001). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of CSI for differentiating NN from neoplastic lesions were 65.9%, 94.6%, 80.6%, 89.1%% and 87.4% respectively, and for differentiating BN from MN were 9.1%, 98.4%, 85.7%, 51.2 and 53.1% respectively. Conclusion: CSI is accurate for differentiating non-neoplastic and neoplastic marrow lesions, but is of no value in differentiating malignant bone tumours from non-fat containing benign bone tumours. Advances in knowledge: CSI is of value for differentiating non-neoplastic marrow lesions from neoplastic lesions, but not for differentiating benign bone tumours from malignant bone tumours as has been previously reported.

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He, L. H., E. Xiao, J. G. An, Y. He, S. Chen, L. Zhao, T. Zhang, and Y. Zhang. "Role of Bone Marrow Stromal Cells in Impaired Bone Repair from BRONJ Osseous Lesions." Journal of Dental Research 96, no. 5 (February 15, 2017): 539–46. http://dx.doi.org/10.1177/0022034517691507.

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Treatment of bisphosphonate-related osteonecrosis of the jaw (BRONJ) has posed significant challenges to maxillofacial surgeons because of the poor repair of BRONJ bone defects. Moreover, the pathological mechanisms remain unclear. Bone marrow stromal cells (BMSCs) play key roles during bone repair and bone regeneration. However, the activities of BMSCs derived from BRONJ lesions and the BRONJ lesion boundary, as well as the roles of BMSCs in BRONJ defect repair, are poorly defined. In this study, we found that BMSCs from the central area of the osteonecrotic BRONJ region (center-BRONJ BMSCs) and the peripheral area at the recommended debridement boundary (peri-BRONJ BMSCs) had decreased proliferative ability, self-renewal capacity, and multidifferentiation capacities compared with control BMSCs. Osteoclast-inducing ability was also impaired in BRONJ BMSCs. All of these results suggested that the decreased activities of BRONJ BMSCs, even the BMSCs derived from the BRONJ lesion boundary, might be an important factor leading to insufficient bone repair of BRONJ lesions. This study offers early stage evidence for the use of marrow stromal cells in the treatment of BRONJ.

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Mendeleeva, L. P., I. G. Rekhtina, A. M. Kovrigina, I. E. Kostina, V. A. Khyshova, N. K. Arytyunyan, W. E. Mamonov, and V. G. Savthenko. "Bone disease as the first manifestation of systemic AL-amyloidosis." Terapevticheskii arkhiv 92, no. 7 (September 1, 2020): 85–89. http://dx.doi.org/10.26442/00403660.2020.07.000775.

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Our case demonstrates severe bone disease in primary AL-amyloidosis without concomitant multiple myeloma. A 30-year-old man had spontaneous vertebral fracture Th8. A computed tomography scan suggested multiple foci of lesions in all the bones. In bone marrow and resected rib werent detected any tumor cells. After 15 years from the beginning of the disease, nephrotic syndrome developed. Based on the kidney biopsy, AL-amyloidosis was confirmed. Amyloid was also detected in the bowel and bone marrow. On the indirect signs (thickening of the interventricular septum 16 mm and increased NT-proBNP 2200 pg/ml), a cardial involvement was confirmed. In the bone marrow (from three sites) was found 2.85% clonal plasma cells with immunophenotype СD138+, СD38dim, СD19-, СD117+, СD81-, СD27-, СD56-. FISH method revealed polysomy 5,9,15 in 3% of the nuclei. Serum free light chain Kappa 575 mg/l (/44.9) was detected. Multiple foci of destruction with increased metabolic activity (SUVmax 3.6) were visualized on PET-CT, and an surgical intervention biopsy was performed from two foci. The number of plasma cells from the destruction foci was 2.5%, and massive amyloid deposition was detected. On CT scan foci of lesions differed from bone lesions at multiple myeloma. Bone fragments of point and linear type (button sequestration) were visualized in most of the destruction foci. The content of the lesion was low density. There was no extraossal spread from large zones of destruction. There was also spontaneous scarring of the some lesions (without therapy). Thus, the diagnosis of multiple myeloma was excluded on the basis based on x-ray signs, of the duration of osteodestructive syndrome (15 years), the absence of plasma infiltration in the bone marrow, including from foci of bone destruction by open biopsy. This observation proves the possibility of damage to the skeleton due to amyloid deposition and justifies the need to include AL-amyloidosis in the spectrum of differential diagnosis of diseases that occur with osteodestructive syndrome.

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Kechagias, N., and H. Tourtouris. "A case report of osteoid osteoma in bone marrow of mandible." Hellenic Archives of Oral & Maxillofacial Surgery 23, no. 1 (April 2022): 35–40. http://dx.doi.org/10.54936/haoms2313540.

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The intrabony lesions of the jawbones are rare pathological situations conditions and their approach requires special knowledge and experience. Osteoid osteoma is a benign lesion of the bones, which is rare in the jawbones, increases slowly and its bigger size reaches roughly 2cm. It is more often developed in the cortical bone, but subperiosteal and rarely intramarrow cases have been reported. The pathogenesis of osteoid osteoma pathogenesis is unknown. Due to the small size of the lesion some authors support, that it is not a tumor but a lesion of vascular etiology. The case report is about a 37 year old female, with radiographical osteosclerotic marks in the bone marrow and pain in the region of 46 after its extraction, due to previous failure of a root canal treatment which was performed two years ago and the continuation of the symptoms.

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Savage-Elliott, Ian, Keir A. Ross, Niall A. Smyth, Christopher D. Murawski, and John G. Kennedy. "Osteochondral Lesions of the Talus." Foot & Ankle Specialist 7, no. 5 (August 5, 2014): 414–22. http://dx.doi.org/10.1177/1938640014543362.

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Osteochondral lesions of the talar dome are increasingly diagnosed and are a difficult pathology to treat. Conservative treatment yields best results in pediatric patients, often leaving surgical options for adult populations. There is a paucity of long-term data and comparisons of treatment options. Arthroscopic bone marrow stimulation is a common first-line treatment for smaller lesions. Despite promising short to medium term clinical results, bone marrow stimulation results in fibrocartilagenous tissue that incurs differing mechanical and biological properties compared with normal cartilage. Autologous osteochondral transplantation has demonstrated promising clinical results in the short to medium term for larger, cystic lesions and can restore the contact pressure of the joint. However, concerns remain over postoperative cyst formation and donor site morbidity. Recent developments have emphasized the usefulness of biological adjuncts such as platelet-rich plasma and concentrated bone marrow aspirate, as well as particulate juvenile cartilage, in augmenting reparative and replacement strategies in osteochondral lesion treatment. The purpose of this article is to review diagnosis and treatment of talar osteochondral lesions so that current practice guidelines can be more efficiently used given the available treatment strategies. A treatment paradigm based on current evidence is described.Levels of Evidence: Therapeutic, Level V, Expert Opinion

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Yasuda, Hiromi, Tadanobu Shimura, Masato Okigami, Shigeyuki Yoshiyama, Masaki Ohi, Koji Tanaka, Yasuhiko Mohri, and Masato Kusunoki. "Esophageal Cancer with Bone Marrow Hyperplasia Mimicking Bone Metastasis: Report of a Case." Case Reports in Oncology 9, no. 3 (November 7, 2016): 679–84. http://dx.doi.org/10.1159/000449525.

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A 63-year-old man visited the clinic with numbness in the right hand. Magnetic resonance imaging demonstrated multiple low-intensity lesions in the cervical vertebrae and sacrum, which was suspicious of cervical bone metastasis. Fluorodeoxyglucose positron emission tomography/computed tomography revealed areas of increased fluorodeoxyglucose uptake in the thoracic esophagus, sternum and sacrum. A flat, elevated esophageal cancer was identified by upper gastrointestinal endoscopy, and the macroscopic appearance indicated early-stage disease. From the cervical, thoracic and abdominal computed tomography images, there were no metastatic lesions except for the bone lesions. To confirm whether the bone lesions were metastatic, we performed bone biopsy. The histopathological diagnosis was bone marrow hyperplasia. It was crucial for treatment planning to establish whether the lesions were distant metastases. Here, we report a case of esophageal cancer with bone marrow hyperplasia mimicking bone metastasis.

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Senapati, Satya Bhusan, Sudhansu Sekhar Mishra, Manmath Kumar Dhir, Srikanta Das, and Kalpalata Tripathy. "A case of multiple myeloma presenting as scalp swelling with intracranial extension." Journal of Neurosciences in Rural Practice 04, no. 04 (October 2013): 445–48. http://dx.doi.org/10.4103/0976-3147.120230.

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ABSTRACTMultiple myeloma is a malignant neoplasm of bone marrow affecting plasma cells. It is usually detected in skull bone with characteristic features of multiple punched-out lesions. Its presentation as a solitary scalp swelling with underlying skull bone erosion and intracranial extension is very rare. A 35-year-old female presented to us with complains of rapidly growing left-side scalp swelling with right-side paresis and simple partial seizure of right upper limb. Local examination, X-ray skull, CT scan, and MRI of brain were suggestive of a malignant lesion. Near total excision of lesion was done. Histopathological study was suggestive of plasmacytoma of skull. Bone marrow study further confirmed it as a case of multiple myeloma. Cases presenting with solitary osteolytic skull lesions, possibility of plasmacytoma, or multiple myeloma should be kept in mind.

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Salkar, Dr Akanksha, Dr Srikant Pankanti, Dr Ranjana Srikant Pankanti, and Dr Vijay Praveen Pedakontala. "Granulomatous Lesions in Bone Marrow: A Case Series." IOSR Journal of Dental and Medical Sciences 15, no. 10 (October 2016): 96–100. http://dx.doi.org/10.9790/0853-15100296100.

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Kwoh, C. Kent. "Clinical relevance of bone marrow lesions in OA." Nature Reviews Rheumatology 9, no. 1 (December 11, 2012): 7–8. http://dx.doi.org/10.1038/nrrheum.2012.217.

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Kornaat, Peter R., and Samuel K. Van de Velde. "Bone Marrow Edema Lesions in the Professional Runner." American Journal of Sports Medicine 42, no. 5 (February 20, 2014): 1242–46. http://dx.doi.org/10.1177/0363546514521990.

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OTTO, M. ALEXANDER. "Bone Marrow Lesions Change Early in Knee OA." Family Practice News 41, no. 16 (October 2011): 38. http://dx.doi.org/10.1016/s0300-7073(11)70862-3.

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Dore, D., C. Ding, and G. Jones. "059 NATURAL HISTORY OF AREAL BONE MARROW LESIONS." Osteoarthritis and Cartilage 17 (September 2009): S40. http://dx.doi.org/10.1016/s1063-4584(09)60082-0.

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Zhong, Connie S., Edward T. Richardson, Alvaro C. Laga Canales, and Vinod E. Nambudiri. "Atypical cutaneous targetoid lesions after bone marrow transplant." BMJ Case Reports 12, no. 8 (August 2019): e230142. http://dx.doi.org/10.1136/bcr-2019-230142.

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A 69-year-old man with esophageal EBV-positive diffuse large B cell lymphoma status post allogeneic bone marrow transplant (BMT) five months prior presented to his oncologist with three days of maculopapular rash that was initially diagnosed as grade 1 graft-versus-host disease and started on oral prednisone. However, due to worsening of the rash, the patient presented to dermatology clinic, where skin biopsy revealed a diagnosis of erythema multiforme (EM). The patient improved with the use of topical steroids. This case highlights the atypical morphology of post-BMT EM and the potential causes for this atypical appearance.

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Gulbahce, H. Evin, Stefan E. Pambuccian, Jose Jessurun, Paul Woodard, Marie E. Steiner, J. Carlos Manivel, Stephen Hite, Norma K. C. Ramsay, and K. Scott Baker. "Pulmonary Nodular Lesions in Bone Marrow Transplant Recipients." American Journal of Clinical Pathology 121, no. 2 (February 2004): 205–10. http://dx.doi.org/10.1309/4hyn1dea718rdm6t.

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Epstein, Joel B., Chris H. Sherlock, and John S. Greenspan. "Hairy leukoplakia-like lesions following bone-marrow transplantation." Aids 5, no. 1 (January 1991): 101–2. http://dx.doi.org/10.1097/00002030-199101000-00016.

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Alliston, Tamara, Christopher J. Hernandez, David M. Findlay, David T. Felson, and Oran D. Kennedy. "Bone marrow lesions in osteoarthritis: What lies beneath." Journal of Orthopaedic Research® 36, no. 7 (May 22, 2018): 1818–25. http://dx.doi.org/10.1002/jor.23844.

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Buda, Roberto, Francesca Vannini, Marco Cavallo, Matteo Baldassarri, Simone Natali, Francesco Castagnini, and Sandro Giannini. "One-step bone marrow-derived cell transplantation in talarosteochondral lesions: mid-term results." Joints 01, no. 03 (July 2013): 102–7. http://dx.doi.org/10.11138/jts/2013.1.3.102.

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Purpose: to verify the capability of scaffold-supported bone marrow-derived cells to be used in the repair of osteochondral lesions of the talus. Methods: using a device to concentrate bone marrow-derived cells, a scaffold (collagen powder or hyaluronic acid membrane) for cell support and platelet gel, a one-step arthroscopic technique was developed for cartilage repair. In a prospective clinical study, we investigated the ability of this technique to repair talar osteochondral lesions in 64 patients. The mean follow-up was 53 months. Clinical results were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) scale score. We also considered the influence of scaffold type, lesion area, previous surgery, and lesion depth. Results: the mean preoperative AOFAS scale score was 65.2 ± 13.9. The clinical results peaked at 24 months, before declining gradually to settle at a score of around 80 at the maximum follow-up of 72 months. Conclusions: the use of bone marrow-derived cells supported by scaffolds to repair osteochondral lesions of the talus resulted in significant clinical improvement, which was maintained over time. Level of Evidence: level IV, therapeutic case series.

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Solovev, M. V., L. P. Mendeleeva, G. A. Yatsyk, N. S. Lutsik, M. V. Firsova, E. G. Gemdzhian, and V. G. Savchenko. "Bone marrow MRI after autologous transplantation and the effect of residual tumor on progression-free survival of multiple myeloma patients." Oncohematology 13, no. 4 (January 3, 2019): 46–53. http://dx.doi.org/10.17650/1818-8346-2019-13-4-46-53.

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Background . The study of influence of residual tumor mass, determined by magnetic resonance imaging (MRI), on the progression-free survival (PFS) remains an actual problem. Since the visual assessment of tumor bone marrow lesion can be one of the criteria for the subsequent personalized treatment choice in multiple myeloma patients.The objective of study was to determine the effect of bone marrow lesions detected by MRI after autologous hematopoietic stem cells transplantation (auto-HSCT) on PFS in multiple myeloma patients.Materials and methods . The prospective study included 60 patients who underwent spine and pelvic bones MRI on the 100 th day after autoHSCT.Results . Focal bone marrow changes were found in 47 of them – from 1 to 56 lesions (mean 6 ± 9). Significant (p = 0.01) differences of PFS in multiple myeloma patients depending on the presence or absence of tumor mass on 100 th day after auto-HSCT were revealed: with MRI negative status, 2-year PFS was 89 % versus 50 % in a group of patients with residual tumor mass.Conclusion . MRI-negative status after auto-HSCT is a favorable prognostic factor contributing to prolonged disease-free survival.

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Schwartz, Michael L., Robert Yeung, Yuexi Huang, Nir Lipsman, Vibhor Krishna, Jennifer D. Jain, Martin G. Chapman, Andres M. Lozano, and Kullervo Hynynen. "Skull bone marrow injury caused by MR-guided focused ultrasound for cerebral functional procedures." Journal of Neurosurgery 130, no. 3 (March 2019): 758–62. http://dx.doi.org/10.3171/2017.11.jns17968.

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OBJECTIVEOne patient for whom an MR-guided focused ultrasound (MRgFUS) pallidotomy was attempted was discovered to have multiple new skull lesions with the appearance of infarcts on the MRI scan 3 months after his attempted treatment. The authors conducted a retrospective review of the first 30 patients treated with MRgFUS to determine the incidence of skull lesions in patients undergoing these procedures and to consider possible causes.METHODSA retrospective review of the MRI scans of the first 30 patients, 1 attempted pallidotomy and 29 ventral intermediate nucleus thalamotomies, was conducted. The correlation of the mean skull density ratio (SDR) and the maximum energy applied in the production or attempted production of a brain lesion was examined.RESULTSOf 30 patients treated with MRgFUS for movement disorders, 7 were found to have new skull lesions that were not present prior to treatment and not visible on the posttreatment day 1 MRI scan. Discomfort was reported at the time of treatment by some patients with and without skull lesions. All patients with skull lesions were completely asymptomatic. There was no correlation between the mean SDR and the presence or absence of skull lesions, but the maximum energy applied with the Exablate system was significantly greater in patients with skull lesions than in those without.CONCLUSIONSIt is known that local skull density, thickness, and SDR vary from location to location. Sufficient energy transfer resulting in local heating sufficient to produce a bone lesion may occur in regions of low SDR. A correlation of lesion location and local skull properties should be made in future studies.

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Looze, Christopher A., Jason Capo, Michael K. Ryan, John P. Begly, Cary Chapman, David Swanson, Brian C. Singh, and Eric J. Strauss. "Evaluation and Management of Osteochondral Lesions of the Talus." CARTILAGE 8, no. 1 (September 28, 2016): 19–30. http://dx.doi.org/10.1177/1947603516670708.

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Osteochondral lesions of the talus are common injuries that affect a wide variety of active patients. The majority of these lesions are associated with ankle sprains and fractures though several nontraumatic etiologies have also been recognized. Patients normally present with a history of prior ankle injury and/or instability. In addition to standard ankle radiographs, magnetic resonance imaging and computed tomography are used to characterize the extent of the lesion and involvement of the subchondral bone. Symptomatic nondisplaced lesions can often be treated conservatively within the pediatric population though this treatment is less successful in adults. Bone marrow stimulation techniques such as microfracture have yielded favorable results for the treatment of small (<15 mm) lesions. Osteochondral autograft can be harvested most commonly from the ipsilateral knee and carries the benefit of repairing defects with native hyaline cartilage. Osteochondral allograft transplant is reserved for large cystic lesions that lack subchondral bone integrity. Cell-based repair techniques such as autologous chondrocyte implantation and matrix-associated chondrocyte implantation have been increasingly used in an attempt to repair the lesion with hyaline cartilage though these techniques require adequate subchondral bone. Biological agents such as platelet-rich plasma and bone marrow aspirate have been more recently studied as an adjunct to operative treatment but their use remains theoretical. The present article reviews the current concepts in the evaluation and management of osteochondral lesions of the talus, with a focus on the available surgical treatment options.

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Nii, A., D. A. Reynolds, H. A. Young, and J. M. Ward. "Osteochondrodysplasia Occurring in Transgenic Mice Expressing Interferon-γ." Veterinary Pathology 34, no. 5 (September 1997): 431–41. http://dx.doi.org/10.1177/030098589703400507.

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In addition to various biological activities, interferon-γ (IFN-γ) inhibits bone resorption and collagen synthesis. We produced a transgenic mouse line expressing the murine IFN-γ gene and protein in the bone marrow and thymus. Forty-five transgenic FVB/NCr mice, 23 days-9 months of age, were studied for anomalies in the skeletal system. The transgenic mice had short, wide, and deformed long bones. Young transgenic mice had epiphyseal plates severely thickened with zones of hypertrophy and degeneration with irregular metaphyseal borders. Cartilagenous masses were also observed in the metadiaphyseal marrow cavities. These lesions were primarily seen in long bones and ribs. Adult transgenic mice had residues of degenerated cartilagenous masses in the diaphyses. Many osteoclasts with well-developed ruffled borders were present on the metaphyseal cartilagenous masses in young transgenic mice. Adult transgenic mice had less prominent primary spongiosa with fewer osteoclasts at the metaphysis as compared with nontransgenic controls. The cortical bones of the transgenic mice were thinner and more immature compared with controls. Transgenic mice also had fractures, disruption of the epiphyseal plate, and degeneration of articular cartilage. Thus, the IFN-γ transgenic mice developed a complex chondro-osseous lesion that was diagnosed as osteochondrodysplasia. The lesions may originate from primarily decreased matrix synthesis in bone and cartilage and also possible osteoclast-related changes caused by IFN-γ overexpression in the bone marrow. Our IFN-γ transgenic mouse will be a useful model to investigate the role of IFN-γ in bone metabolism.

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Liu, Yu, and Kaicheng Li. "Solitary plasmacytoma of maxillofacial bones: correlation of CT features with pathological findings." Dentomaxillofacial Radiology 49, no. 1 (January 2020): 20190277. http://dx.doi.org/10.1259/dmfr.20190277.

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Objective: To explore the CT features of solitary plasmacytoma (SP) of maxillofacial bones and correlation with pathological findings. Methods and materials: We retrospectively reviewed the clinical, CT and pathological features of SP in the maxillofacial bones. 16 patients with clinically and histologically proven SP of maxillofacial bones were involved. They were aged from 27 to 79 years old (median 55.5 years old), and included 12 males and 4 females (males vs females: 3:1). All patients performed CT examination, in whom 13 patients underwent enhanced scanning and 3 plain scanning. The CT images were assessed for lesion location, size (maximum diameter), shape (round, oval and irregular), boundary (defined and illdefined), bone changes (bone destruction, residual bone, sclerotic margin and periosteal reaction), density of soft tissue mass and enhancement manifestations, and invasion of adjacent structures. Results: 13 patients suffered from SP in the mandible, 2 in the zygoma, and 1 in the maxilla and hard palate. The maximum diameter of lesions ranged from 2.4 to 8.2 cm (mean 3.93 ± 1.435 cm). Most lesions were founded as a solitary osteolytic lesions (15/16, 93.75%) with round or ovoid shape (13/16, 81.25%), smooth margin (16/16, 100%) and defined boundary (16/16, 100%) in bone marrow. They destroyed bone cortex (15/16, 93.75%) and had residual bone (10/16, 62.5%), without sclerosis margin (15/16, 93.75%) and periosteal reaction (14/16, 87.5%). They easily formed soft tissue masses (16/16, 100%) and invade adjacent anatomical structures (15/16, 93.75%). The density of lesions was usually uniform (12/16, 75%) with strong enhancement. There was a significant difference in CT values between plain and enhanced scanning [50.75 ± 9.140 Hounfield unit (HU) vs 101.0 ± 28.830 HU; p < 0.001), with the mean difference of CT values 50.25 HU. Conclusions: SP is predominant in the mandible of elderly male patients. A solitary, round or ovoid, well-defined, osteolytic, invasive mass in bone marrow, which destroys bone cortex, has residual bone, no sclerosis margin and periosteal reaction, and shows strong enhancement, is suggestive of this diagnosis.

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Mahmood, Khalid, Muhammad Ubaid, and Syeda Taliya Rizvi. "Multiple Osteolytic Lesions Causing Hypercalcemia: A Rare Presentation of Acute Lymphoblastic Leukemia." Case Reports in Medicine 2017 (2017): 1–3. http://dx.doi.org/10.1155/2017/2347810.

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Acute lymphoblastic leukemia is characterized by unchecked proliferation of malignant lymphoblasts which replaces the normal bone marrow culminating in anemia due to red blood cells inadequacy as well as in easy bruising/bleeding secondary to insufficient platelets production. Even the white blood cells which are produced excessively are immature and abnormal. ALL is the most common hematological malignancy in children. Most commonly, patients present with lymphadenopathy, recurrent infections, bleeding, fatigue, and bone pains. Bone pains, often particularly involving long bones, occur in about 21–38% of cases and are due to overcrowding of bone marrow with malignant cells. Vast majority of children with ALL have thrombocytopenia and/or anemia with a normal or mildly elevated white blood cells count with the presence of lymphoblasts on peripheral smear. About 50% of children present with bleeding while about 75% of patients have platelet count 100,000/microL. Visceromegaly is not uncommon but osteolytic lesions and hypercalcemia are rather uncommon. We present a 22-year-old gentleman with generalized fatigue and bone pains without visceromegaly. There was severe hypercalcemia with normal parathyroid levels but multiple osteolytic lesions. Peripheral smear showed anemia without blasts, whereas a bone marrow biopsy revealed > 30% blasts with interspersed CD 10 positive cells.

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Journal articles on the topic 'Bone marrow lesions'

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