case_images: PMC2811304_01
case_images: Scanning findings for bones. (A) Disseminated hypermetabolic lesion (maxSUV=9.0, L2 body) at the whole spine by PET. A hypermetabolic lesion suggesting a primary malignant lesion was not detected in the lung, intraabdominal and pelvic organs. (B) No increased bone uptake of hypermetabolic lesions on bone scan, with little osteoblastic effect.
case_images: jkms-25-313-g001.jpg
case_images: PMC2811304_01_jkms-25-313-g001.jpg
case_images: F1
case_images: Although fusion whole body positron emission tomography (PET) showed lesions indicative of multiple bone metastases (Fig. 1A), a bone scan showed little osteoblastic reaction (Fig. 1B).
case_images: Diffuse and heterogeneous T1 and T2 showing low SI changes in the lower thoracic and lumbar spine with subtle enhancement.
case_images: jkms-25-313-g002.jpg
case_images: PMC2811304_01_jkms-25-313-g002.jpg
case_images: F2
case_images: Because there was no evidence of malignancy on chest, abdominal and pelvic CT and prostate ultrasonography, we performed lumbar spine magnetic resonance imaging (MRI) (Fig. 2).
case_images: Histopathological findings of bone marrow biopsy. (A) Non-cohesive proliferation of large pleomorphic neoplastic cells with large round-to-oval nuclei with vesicular chromatin and abundant foamy cytoplasm (H&E stain, x400). Immunostaining with antibodies to (B) CD99, (C) CD68, (D) CD56, (E) HMB45 (each, x100) and (F) S100 (x200).
case_images: jkms-25-313-g003.jpg
case_images: PMC2811304_01_jkms-25-313-g003.jpg
case_images: F3
case_images: The BM biopsy, however, revealed a diffuse non-cohesive proliferation of pleomorphic neoplastic cells with large round to oval nuclei, vesicular chromatin and abundant foamy eosinophilic cytoplasm (Fig. 3).