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Epidemiology
Acute lymphoblastic leukemia is the commonest form of childhood leukemia. It
accounts for 80% of pediatric leukemia cases but only 20% in adults . Peak
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Clinical presentation
The clinical features of acute lymphoblastic leukemia are non-specific.
Children commonly have at least one of pallor, fever, a palpable liver, a
palpable spleen, or bruising on diagnosis . Other symptoms such as bone or
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joint pain, weight loss, anorexia, bleeding, abdominal pain and abdominal
distension are also common.
Pathology
In acute lymphoblastic leukemia, the lymphoid progenitor cells, also known as
lymphoblasts, do not mature due to abnormal expression of genes, often as a
result of chromosomal abnormalities or chromosomal translocations. The
proliferation of the primitive cells takes up more and more marrow space at
the expense of the normal hematopoietic elements, resulting in a decrease in
production of normal blood cells and bone marrow failure. Eventually, the
lymphoblasts spill into the blood and can affect the liver, spleen, central
nervous system, and lymph nodes.
Radiographic features
Plain radiograph
Bone lesions are common in leukemia. A metaphyseal radiolucent band is one
of the most important radiological finding . Other radiological findings include
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Differential diagnosis
juvenile idiopathic arthritis
osteomyelitis
aplastic anemia
acute infectious lymphocytosis
https://radiopaedia.org/articles/acute-lymphoblastic-leukaemia