ArticleFrontiers in oncology2026
Early imaging differentiation of children with acute hematologic malignancies that present in pancytopenia: a retrospective study.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objectives: This retrospective cohort study aimed to identify potential differentiation indicators on thoracic and abdominal computed tomography (CT) among three hematologic malignancies characterized by acute pancytopenia in children. Methods: This study was conducted at the Children's Hospital of Chongqing Medical University, Chongqing, China. A total of 133 children with acute pancytopenia from August 2016 to November 2024 were enrolled, including 23 with malignancy-associated hemophagocytic lymphohistiocytosis (M-HLH), 58 with acute leukemia (AL), and 52 with Epstein-Barr virus-associated HLH (EBV-HLH). The differences in thoracic and abdominal CT features were statistically analyzed. Results: Chest CT showed significant intergroup differences in pulmonary lesions, thickening of the bronchiovascular bundle, and pleural effusion. Mediastinal largest lymph nodes (LLNs) in M-HLH were significantly larger, with receiver operating characteristic (ROC)-derived cutoff values of 11.45 mm (M-HLH vs. AL, sensitivity 65.2%, specificity 98.2%) and 11.60 mm (M-HLH vs. EBV-HLH, sensitivity 65.2%, specificity 100%), predominantly located in the retroinnominate space. Abdominal CT revealed significant differences in widened periportal space, ascites, splenomegaly, and intrarenal lesions. Abdominal LLNs in M-HLH were larger, with cutoff values of 9.3 mm (M-HLH vs. AL, sensitivity 72.7%, specificity 77.2%) and 9.60 mm (M-HLH vs. EBV-HLH, sensitivity 72.7%, specificity 75.0%). Conclusions: Thoracic and abdominal CT manifestations are usually different among pediatric hematologic malignancies that present in acute pancytopenia, providing valuable supportive clues for differential diagnosis.
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