All issues > Volume 26(2); 1983

Original Article

J Korean Pediatr Soc. 1983;26(2):143-150. Published online February 28, 1983.

Bone Changes in Childhood Leukemia.

In Soo Choi¹, Jong Soo Kim¹, Jung Soo Kim¹, Kyu Cha Kim¹, Yea Seong Youn²

¹Department of Pediatrics，Jeonbug National University Medical School
²Department of Radiology、Jeonbug National University Medical School

Abstract

Leukemia, the most common malignant disease in pediatric field, is one of the most interesting targets of modern medical research. So we reviewed the bone changes in 51 patients of leukemia admitted to the Dept, of Pediatrics Jeonbug National University Hospital for 5 years from Jan. 1st 1977 to Dec. 31st 1981. The results were as follow. The male patient was more prevalent with sex ratio male to female 2.7 : 1, and the highest incidence was noticed between 2 years and 4 years of age(23.5%) and followed by between 6 years and 8 years of age(21. 6%). Acute lymphocytic leukemia occurred in 62.7% (32 cases) and acute myelocytic leukemia in 33.3% (17 cases), chronic myelocytic leukemia in 2%(1 cases), acute monocytic leukemia in 2%(1 cases). The most common symptoms and signs on admission was fever(56.9%), and followed by lymphadenopathy (52.9%), pallor(52. 9%), hepatosplenomegaly (49.0%) in order of incidence. The most common chief complaint on admission was fever (39. 2%), and followed by pallor (37.3%), and generalized malaise(25.5%). The patients with hemoglobin value under 4. 0 gm% occupied 21.6% and about two thirds showed hemoglobin less than 8.0 gm%. The leukocyte counts on admission between 5,000 and 10,000/mm3 was noticed in 6 cases (11.8%) and lower than 5,000/mm3 in 8 cases(15.7%). In the chest X-ray the most common osseous change was metaphyseal band of humerus in 24 cases(47.1%), and followed by metaphyseal cortical scalloping of upper humerus in 39. 2%, osteolytic change in 31.4%, periosteal reaction in 7.8%, osteosclerosis in 2%. The most common extrasseous change in chest X-ray was mediastinal widening with hilar lymphadenopathy in 31.4%, and followed by pulmonary infiltration in 29.4%, pleural reaction in 5. 9%. The twelve cases in which hematologic change were mild, showed radiologic abnormalities in 10 cases(83%), and the 39 cases in which hematologic changes were severe, showed radiologic abnormalities in 31 cases (79%). Between these two hematologic group the incidence of cortical scalloping of upper humerus was not differ significantly. The osseous changes were noticed in 75% of ALL and 47% ofAML, and the extraosseous changes were noticed in 60% of ALL and 47% AML.

Keywords :Leukemia-radiologic studies; Cortical erosion of upper humerus.