title: Case series of pediatric acute leukemia without a peripheral blood abnormality, detected by magnetic resonance imaging.
abstract: Although abnormal peripheral blood counts are a key diagnostic finding for acute leukemia in children, between 2003 and 2010 we observed seven pediatric cases without peripheral blood abnormalities and showing abnormal signals in the bone marrow by magnetic resonance imaging (MRI). The common chief complaint in these patients was bone pain and fever. Bone marrow tests revealed six out of the seven cases to be acute leukemia, whereas one patient was diagnosed with juvenile idiopathic arthritis (JIA). There was no evident difference in MRI findings between leukemia patients and JIA patient. In three cases of leukemia, initial bone marrow aspiration failed to show the presence of leukemic cells, and diagnosis was only made by repeated bone marrow examination. Our findings indicate that in some cases MRI detects leukemia at an earlier phase than does bone marrow aspiration, suggesting that MRI is useful for the diagnosis of acute leukemia.
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kato
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan. kkoh-tokyo@umin.ac.jp.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Koh
authors.affiliation: Department of Pediatrics, Teikyo University, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kikuchi
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Toyama
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Mochizuki
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Uchisaka
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nagatoshi
authors.affiliation: Department of Infectious Diseases/Immunology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Risa
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Infectious Diseases/Immunology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Oh-Ishi
authors.affiliation: Department of Radiology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Nozawa
authors.affiliation: Department of Radiology, Saitama Children's Medical Center, Saitama, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Oguma
authors.affiliation: Department of Hematology/Oncology, Saitama Children's Medical Center, 2100 Magome, Iwatsuki-ku, Saitama, Japan.
authors.forename: Ryoji
authors.initials: R
authors.lastname: Hanada
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001853:Bone Marrow / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007621:Karyotyping; D007938:Leukemia / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents