This case mandates: 1) routine TdT staining for LCH-like lesions, 2) recognition of KRAS-driven osteolysis as a novel B-ALL mechanism, and 3) implementation of molecular profiling in atypical osteolytic cases. It highlights the need for integrated diagnostic approaches combining imaging, pathology, and molecular techniques in pediatric bone lesions.
Xiao et al. (Thu,) studied this question.