A young male with bone pain.

Area of Science:

• Hematology
• Oncology
• Medical Diagnostics

Background:

• Bone pain is a common symptom with diverse etiologies.
• Normal peripheral blood counts can sometimes mask serious underlying hematological conditions.

Purpose of the Study:

• To report a case of acute biphenotypic leukemia presenting with bone pain and normal blood counts.
• To emphasize the importance of considering hematological malignancies in patients with unexplained bone pain.

Main Methods:

• Case presentation of a 38-year-old male with a 6-month history of right thigh pain and weight loss.
• Initial investigations included normal blood counts, biochemistry, and inflammatory markers.
• Advanced imaging (bone scan, MRI) and bone marrow biopsy were performed.

Main Results:

• Preliminary investigations, including peripheral blood count, were normal.
• Elevated inflammatory markers were noted.
• Bone scan and MRI suggested a leukaemic process, confirmed by bone marrow biopsy as acute biphenotypic leukaemia.

Conclusions:

• Acute biphenotypic leukaemia can present insidiously with bone pain and normal peripheral blood counts.
• Bone pain in adults warrants thorough investigation, including hematological assessment, to rule out acute leukaemic disorders.
• This case underscores the diagnostic challenge of hematological malignancies presenting atypically.