Bone Lesions Caused by Acute Lymphoblastic Leukemia Initially Diagnosed as Osteomyelitis -A Report of Two Cases-

Abstract

Case 1: A 12-year-old boy complained of right buttock pain and high fever. Radiographic examinations demonstrated osteolytic lesion in his right iliac bone. He was treated with several antibiotics and his symptoms disappeared for two months. However, the fever increased again and atypical lymphocytes appeared in peripheral blood. Acute lymphoblastic leukemia (ALL) was diagnosed by myelocentesis.
Case 2: A 3-year-old girl complained of right leg pain and high fever. Radiographic examinations demonstrated osteolytic lesion and periosteal reaction in her right tibia. She was treated with several antibiotics and her symptoms disappeared for two months. However, she suffered both fever and forearm pain again. Radiographic examinations revealed osteolytic lesions with periosteal reactions in both radius and ulna, which resembled Caffey's disease. Abnormal findings were not seen by bone biopsy and her symptom did not respond to antibiotic therapy. Atypical lymphocytes appeared in peripheral blood one week after bone biopsy and ALL was confirmed by myelocentesis.
Both patients responded well to chemotherapy and have kept remission.