Background: Acute promyelocytic leukemia is a subtype of acute myeloid leukemia most noted for a high rate of cure with prompt treatment and high early mortality if unrecognized, typically presenting with symptoms of bone marrow failure and lifethreatening coagulopathy. Case Presentation: We report the case of a patient who was found to have this unexpected diagnosis during workup of persistent back pain following a fall. In this example, the incidental finding of abnormal bone marrow signal on magnetic resonance imaging prompted a bone marrow biopsy which confirmed the diagnosis. Conclusion: This case highlights the significance and emerging role of imaging techniques in identifying abnormalities in the bone marrow which may provide the initial clues and support the timely diagnosis of hematological malignancies.

Keywords: Acute promyelocytic leukemia, case report, magnetic resonance imaging.