J Korean Radiol Soc.  1982 Dec;18(4):716-723. 10.3348/jkrs.1982.18.4.716.

Detection of childhood leukemia by chest P-A and its early diagnostic value

• Youn YS
• Kang TW
• Kim JK
• Choi IS

• KMID: 2463239
• DOI: http://doi.org/10.3348/jkrs.1982.18.4.716

Abstract

Leukemia, the most common malignant disease in the pediatric field, is one of the most interesting targets ofmodern medical research. So we reviewed the bone changes in 51 patients of leukemia admitted to the Dept. ofPediatrics Jeonbug National University Hospital for 5 years from Jan. 1st 1977 to Dec. 31st 1981. The results wereas follow. The male patient was more prevalent with sex ratio male to female 2.7:1, and the highest incidence wasnoticed 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), chronicmyelocytic leukemia in 2%(1 case), acute monolcytic leukemia in 2%(1 case). The most common symptoms and signs onadmission was fever (56.9%), and followed by lymphadenopathy(52.9%), hepatosplenomegaly (49.0%) in order ofincidence. The most common chief complaint on admission was fever (39.2%), and followed by pallor (37.3%), andgeneralized malaise (25.5%). The patients with hemoglobin value under 4.0m% occupied 21.6% and about two thirdsshowed hemoglobin less than 8.0m%. The leukocyte counts on admission between 5,000 and 1,10,000/mm3 was noticed in6 cases(11.85) and lower than 5,000/mm3 in 8 cases (15.7%). In the chest X-ray the most common osseous change wasmetaphseal band of humerus in 24 cases (47.1%) , and followed by metaphseal cortical scalloping of upper humerusin 39.2%, osteolytic change in 31.4% periosteal reaction in 7.8%, osteosclerosis in 2%. The most common extraosseous change in chest P-A was mediastinal widening with hilar lymphadenopathy in 1.4% and followed by pulmonary infiltration in 29.4%, pleural reaction in 5.9%. The twelve cases in which hematologic changes weremild, showed radiologic abnormalities in 10 cases (83%), and the 39 cases in which hematologic changes were severe, showed radiologic abnormalities in 31 cases(79%). Especially, In hematologic mild group, showed metaphyseal cortical scalloping of proximalhumerus in 5 cases (41 %), and in hematologic severe group, showed metaphyseal cortical scalloping of proximal humerus in 15 cases (40%). 50 metaphyseal contical scalloping of proximal humerus may be the key finding on detection of early childhood leukemia. The osseous changes were noticed in 75% of ALL, and 47% of AM L, and the extraosseous changes were noticed in 60% of ALL, and 47% of AML.

MeSH Terms

Female
Fever
Humans
Humerus
Incidence
Jeollabuk-do
Leukemia*
Leukemia, Lymphoid
Leukemia, Myeloid, Acute
Leukocyte Count
Lymphatic Diseases
Male
Osteosclerosis
Pallor
Pectinidae
Sex Ratio
Thorax*