title: Bone Marrow Involvement in Unknown Acute Myeloid Leukemia Detected by 18F-FDG PET/MRI.
abstract: A 83-year-old patient with inflammatory syndrome, unknown fever, and intense lumbar pain underwent diagnostic imaging for suspicion of spondylodiscitis. Fused F-FDG PET/MRI images showed heterogeneous hypermetabolism in the lumbar spine characterized by infiltrative lesions and adjacent necrotic tissue. Peripheral blood analysis revealed leukoerythroblastic changes, whereas bone marrow biopsy was highly hypercellular and revealed an acute myeloid leukemia with 70% infiltration of blasts of erythroid lineage. The intensive lumbar pain and elevated lactate dehydrogenase level are suggestive of bone marrow necrosis as seen in the PET/MRI. Our case emphasizes the usefulness of fused PET/MRI imaging for metabolic characterization of AML.
authors.affiliation: From the Departments of *Nuclear Medicine and PET/CT Center, and †Oncology/Hematology, Oncology Institute of Southern Switzerland, Bellinzona; and ‡Department of Medicine, Civico Hospital, Lugano, Switzerland.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Paone
authors.forename: Georg
authors.initials: G
authors.lastname: Stüssi
authors.forename: Marco
authors.initials: M
authors.lastname: Pons
authors.forename: Luca
authors.initials: L
authors.lastname: Giovanella
authors.forename: Luca
authors.initials: L
authors.lastname: Ceriani
mesh_terms: D000369:Aged, 80 and over; D001853:Bone Marrow / Q000000981:diagnostic imaging* / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18