Case report 429

Aoki, Jun; Yamamoto, Itsuo; Hino, Megumu; Torizuka, Kanji; Uchiyama, T; Uchino, Haruto

doi:10.1007/bf00350970

Cited by 5 publications

(6 citation statements)

References 11 publications

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“…In the case of the PTHrP-induced osteolysis, activated osteoclasts were noted in the area of bone resorption, without tumor cell invasion (Fig. 1B), as reported previously (Ohuchida et al 1985;Aoki et al 1987). This aberrant PTHrP secretion caused changes similar to those observed in hyperparathyroidism, including subperiosteal resorption and central punched-out lesions known as brown tumors.…”

Section: Introductionsupporting

confidence: 85%

“…Although overall imaging findings in ATLL are non-specific, osteolysis as a paraneoplastic syndrome is a relatively characteristic feature. Paraneoplastic osteolysis due to PTHrP produced by ATLL cells was described in 1980s (Ohuchida et al 1985;Aoki et al 1987;Austin et al 1987;Kessar et al 1996), but most such reports were only in case reports, and the patterns of osteolysis have not been well characterized. PTHrP-induced osteolysis seems to be a relatively common phenomenon in overall malignancies, but cases with severe osteolysis suitable for imaging analysis are rare and mainly seen in ATLL.…”

Section: Discussionmentioning

confidence: 99%

“…In acute ATLL, bone resorption is uncommon, but was reported in several case reports (Ohuchida et al 1985;Aoki et al 1987;Austin et al 1987;Kessar et al 1996). Bone changes consist of two types: tumor-cell infiltration into the bone marrow and paraneoplastic syndrome with no tumor infiltration.…”

Section: Introductionmentioning

confidence: 99%

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Hand Osteolysis in Patients with Adult T-Cell Leukemia-Lymphoma: Radiographic Characteristics

Ehara

Takahashi

Nishida

et al. 2015

Tohoku J. Exp. Med.

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Adult T-cell leukemia-lymphoma (ATLL) is caused by human T-cell lymphotrophic virus I (HTLV-I) infection. Among ATLL cases, 70% of patients present with leukemia and the remaining patients present with lymphoma. Hand osteolysis in the patients with ATLL is considered as paraneoplastic syndrome and caused by parathyroid hormone-related peptide (PTHrP) released from tumor cells. Radiographic features are similar to hyperparathyroidism, but the distribution of osteolysis in hands appears to be slightly different with the authors' experiences. The objective of this study was to identify radiographic characteristics of hand osteolysis associated with ATLL. We included six ATLL patients (5 men and 1 woman; age range, 45-71 years). All the patients presented with acute leukemia, and three were associated with hypercalcemia and pain in various locations including hands. Patterns of osteolysis on hand radiographs were evaluated and recorded independently by three musculoskeletal radiologists. We analyzed the distribution of the bone resorption in the ray distribution of the hand, finger predilection, and the difference between the ulnar and radial sides. The bone resorption was characterized by frequent involvement of the distal and proximal phalanges, predilection of ring fingers and prominent involvement on the ulnar side, compared with frequent involvement of proximal and middle phalanges, index and middle fingers, and on the radial side in the bone resorption of typical hyperparathyroidism. Such distribution may be a characteristic feature of hand osteolysis in patients with ATLL. The present findings are helpful for physicians to differentiate PTHrP-mediated osteolysis in ATLL from parathyroid hormone-mediated hyperparathyroidism.

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Section: Introductionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Hand Osteolysis in Patients with Adult T-Cell Leukemia-Lymphoma: Radiographic Characteristics

Ehara

Takahashi

Nishida

et al. 2015

Tohoku J. Exp. Med.

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“…5). [13][14][15] Abnormally high accumulations on bone scans were reported to indicate the elevated level of serum calcium and poor prognosis. 16 Two major radiographic appearances of osteolytic lesions have been reported in ATL: "punched-out" lesions resembling multiple myeloma and osteolytic metastasis and subperiosteal bone resorptions similar to those in hyperparathyroidism.…”

Section: Skeletal Manifestationsmentioning

confidence: 99%

“…16 Two major radiographic appearances of osteolytic lesions have been reported in ATL: "punched-out" lesions resembling multiple myeloma and osteolytic metastasis and subperiosteal bone resorptions similar to those in hyperparathyroidism. [13][14][15] Punched-out lesions are usually observed in multiple myeloma and in osteolytic metastasis, where tumor ADULT T-CELL LEUKEMIA/AOKI ET AL. cells are located in the medullary cavity and erode the endosteal margins of the cortex.…”

Section: Skeletal Manifestationsmentioning

confidence: 99%

Adult T-Cell Leukemia

Aoki

Sato²,

N³

et al. 2001

Semin Musculoskelet Radiol

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Adult T-cell leukemia (ATL) is endemic in southwestern Japan, in the Caribbean islands, and in central Africa. Human T-cell lymphotropic virus type I (HTLV-I) is the etiologic agent of ATL. The clinical characteristics are (1) onset in adulthood, (2) subacute or chronic leukemia with rapidly progressive terminal course, (3) frequent skin lesions, (4) lymphadenopathy that characteristically spares the mediastinum, (5) hepatosplenomegaly, (6) hypercalcemia, and (7) a tendency toward geographical clustering. Although hypercalcemia and osteoclastic activity due to parathyroid hormone-related peptide are frequently reported histologically, radiographic abnormalities of bone are not common. Two major patterns of osteolytic lesions observed in ATL are "punched-out" lesions resembling multiple myeloma and osteolytic metastasis and subperiosteal bone resorptions similar to those in hyperparathyroidism.

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Skelettveränderungen bei hämatologischen Systemerkrankungen

Skeletterkrankungen

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Case report 429

Cited by 5 publications

References 11 publications

Hand Osteolysis in Patients with Adult T-Cell Leukemia-Lymphoma: Radiographic Characteristics

Hand Osteolysis in Patients with Adult T-Cell Leukemia-Lymphoma: Radiographic Characteristics

Adult T-Cell Leukemia

Skelettveränderungen bei hämatologischen Systemerkrankungen

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