Fig.Case 1. Osteogenic ALL. CT-guided biopsy of L3 body with posterolateral approach using 16G Ossiris（Hakko, Japan）（a）histologically revealed osteogenic acute lymphocytic leukemia, B-cell type（c ; biopsied 4.9mm-long specimen, d ; HE and CD79a stains）in a 43-year-old man with lumbago and left humeral pain persisting for 10 months. Tumor markers and general surveys of lung, abdomen, and GI were all negative, while Tc scintigram showed uptake in the spine, left humerus and right femur（b）.