LAUSR

A 40-year-old man with a history of Human immunodeficiency virus (HIV) positive sorology non-adherent to treatment complaining of back pain and left leg pain despite the use of usual painkillers. A Computed tomography (CT) of the left leg was performed and identified lytic lesions. The blood tests revealed hemoglobin of 11,6 g/dL, White blood cells (WBC) 153.350/mm3 with staggered deviation to promyelocytes, and platelets of 664.000/mm3. The radiograph shows a lytic lesion in proximal tibia (Figure 1A). CT reports hypoattenuating osteolytic images in the femur and tibia lateral condyles associated with cortical defect of the lateral tibia metaphysis (Figure 1B). The Magnetic resonance imaging (MRI) demonstrates a heterogeneous pattern of bone marrow with sparse focal areas some with a nodular aspect (Figure 1C). The Positron Emission Tomography and Computed Tomography (PET-CT) indicates an important axial and appendicular skeleton metabolic activity along with a T5-L2 vertebrae lesion (Figure 1D). A bone marrow biopsy was performed, and the diagnosis of chronic myeloid leukemia was confirmed. Philadelphia chromosome and p210 BCR-ABL were positive. He has also undergone a biopsy of the verte-