title: Acute myelofibrosis: multifocal bone marrow infiltration detected by scintigraphy and magnetic resonance imaging.
abstract: Acute myelofibrosis is a rare, malignant hematological disorder of unknown etiology with an inevitably fatal outcome. Here we present the study of a 63-year-old Caucasian man with acute onset of pancytopenia. Repeated bone marrow biopsies showed dense fibrosis and hypoplastic hematopoiesis raising various differential diagnoses of malignant and nonmalignant conditions. Bone marrow scintigraphy and magnetic resonance imaging (MRI) showed areas suggesting neoplastic infiltration, mainly in both femurs and tibias. Histological examination of a surgical biopsy of the left tibia revealed acute megakaryoblastic leukemia. As the patient refused polychemotherapy, therapy with interferon gamma was initiated but discontinued prematurely because of intolerable side effects. The presented case therefore suggests that the combination of bone marrow scintigraphy and MRI is a valuable diagnostic tool in patients presenting with myelofibrosis of unknown origin.
authors.affiliation: Department of Medicine, Karl-Franzens University School of Medicine, Graz, Austria.
authors.forename: W
authors.initials: W
authors.lastname: Olipitz
authors.forename: C
authors.initials: C
authors.lastname: Beham-Schmid
authors.forename: R
authors.initials: R
authors.lastname: Aigner
authors.forename: J
authors.initials: J
authors.lastname: Raith
authors.forename: W
authors.initials: W
authors.lastname: Linkesch
authors.forename: H
authors.initials: H
authors.lastname: Sill
mesh_terms: D000208:Acute Disease; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007371:Interferon-gamma / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010982:Platelet-Derived Growth Factor / Q000037:antagonists & inhibitors; D055728:Primary Myelofibrosis / Q000175:diagnosis; D011877:Radionuclide Imaging; D013977:Tibia / Q000473:pathology; D016212:Transforming Growth Factor beta / Q000037:antagonists & inhibitors
chemical_list: D000970:Antineoplastic Agents; D010982:Platelet-Derived Growth Factor; D016212:Transforming Growth Factor beta; D007371:Interferon-gamma