以骨量低下、多发骨破坏为首发临床表现的急性淋巴细胞白血病

Low bone mass and multiple osteolytic lesions as the first clinical manifestation of acute lymphocytic leukemia

以骨量低下、多发骨破坏为首发临床表现的急性淋巴细胞白血病少见。本文报道1例17岁男性患者,临床表现为多发骨痛,双能X线吸收法骨密度测量提示骨量低下、骨质疏松,骨X线片发现全身多发骨质破坏及第1腰椎压缩骨折,最终依靠骨髓涂片诊断急性淋巴细胞白血病。以不能解释的骨量低下、多发骨破坏为主要临床表现的儿童和青少年患者,应考虑到急性白血病可能性,需完善骨髓涂片检查以避免漏诊。

Acute lymphocytic leukemia （ALL）, seldom presents as low bone mass and multiple osteolytic lesions at the beginning. The first clinical manifestation, is extremely rare. A 17-year-old boy was admitted to our hospital with severe bone pain. Measurement of bone mineral density by dual energy x-ray absorptiometry revealed low bone mass and osteoporosis. X-ray of bones showed muhiple osteolytic lesions and compression fracture of L1 vertebral body. ALL was diagnosed by bone marrow examination. Conclusion： Children and adolescent patients suffered mainly from inexplicable low bone mass and multiple osteolytic lesions should be suspected acute leukemia, and bone marrow examination should be performed in order to avoid missed diagnosis of leukemia.