I had a MRI of my left knee, due to some knee pain. Report reads: "There is a heterogeneous marrow pattern with areas of abnormal marrow signal in the posterior tibial metaphysis and anterior femoral metaphysis. A patchy abnormal marrow signal in the femor and the tibia could represent leukemic infiltration or heterogeneous red marrow reconversion"
I am currently 2 years in remission from Acute Lymphocyctic Leukemia, and 6 months away from finishing maintenance chemotherapy. My oncologist, said he discussed the report with other radiologists, and they feel the cancer is not coming back. I followed up with the orthopaedic doctor, and he has no idea why I came back to him, and said that there was no dead bone cells in my knee and he cleared me.
Should I be concerned about the possibility of leukemic infiltrates? If so, why hasn't my oncologist stopped me for further testing?
Normal bone marrow has yellow marrow and red marrow. Yellow marrow is more of fat and red marrow is more of haematopoitic tissue. in infants marrow is predominantly hematopoietic with the exception of epiphyses & apophyses, which are predominantly fatty throughout life. with skeletal growth, red marrow is gradually replaced by fat. red marrow persistis longer in the vertebrae, pelvic bones, sternum, & proximal ends of the long tubular bones, during normal marrow conversion, residual islands of red marrow may subsist in the yellow marrow, as may fatty foci in red marrow.islands of red marrow residue may be a normal variant especially in obese women, cigarette smokers, marathon runners. It may be pathological some times in cases of hemolytic processes / anemia.
However in your case u already have leukemia and altered signal in the marrow may indicate red marrow reconversion or leukemic infiltrates and on MRI alone it is difficult to say what is the possibility. Your oncologist is the best judge.
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