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

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Title: Hand Osteolysis in Patients with Adult T-Cell Leukemia-Lymphoma: Radiographic Characteristics
Authors: Ehara, Shigeru / Takahashi, Kei / Nishida, Jun / Uetani, Masataka / Ohashi, Kenjirou / Aoki, Takatoshi
Issue Date: 15-May-2015
Publisher: 東北ジャーナル刊行会 / Tohoku University Medical Press
Citation: The Tohoku Journal of Experimental Medicine, 236(1), pp.63-69; 2015
Abstract: 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.
Keywords: Adult T-cell leukemia-lymphoma / Hyperparathyroidism / Osteolysis / Parathyroid hormone-related peptide / Radiography
URI: http://hdl.handle.net/10069/35492
ISSN: 00408727
DOI: 10.1620/tjem.236.63
Rights: © 2015 Tohoku University Medical Press
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/35492

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