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The document discusses bone tumors, including:
1. It describes primary bone tumors that produce bone or cartilage, such as osteosarcoma and chondrosarcoma, as well as miscellaneous tumors like Ewing's sarcoma.
2. Radiology can provide clues to the nature of bone tumors through characteristics of bone destruction patterns, periosteal reactions, tumor matrix, location in the bone, and bone density changes. Features like "moth-eaten" bone destruction or onion-peel periosteal reactions suggest more aggressive tumors.
3. Common primary bone tumors tend to occur in specific locations, like adamantinoma in the tibia or chordoma in the sacrum
The document discusses bone tumors, including:
1. It describes primary bone tumors that produce bone or cartilage, such as osteosarcoma and chondrosarcoma, as well as miscellaneous tumors like Ewing's sarcoma.
2. Radiology can provide clues to the nature of bone tumors through characteristics of bone destruction patterns, periosteal reactions, tumor matrix, location in the bone, and bone density changes. Features like "moth-eaten" bone destruction or onion-peel periosteal reactions suggest more aggressive tumors.
3. Common primary bone tumors tend to occur in specific locations, like adamantinoma in the tibia or chordoma in the sacrum
The document discusses bone tumors, including:
1. It describes primary bone tumors that produce bone or cartilage, such as osteosarcoma and chondrosarcoma, as well as miscellaneous tumors like Ewing's sarcoma.
2. Radiology can provide clues to the nature of bone tumors through characteristics of bone destruction patterns, periosteal reactions, tumor matrix, location in the bone, and bone density changes. Features like "moth-eaten" bone destruction or onion-peel periosteal reactions suggest more aggressive tumors.
3. Common primary bone tumors tend to occur in specific locations, like adamantinoma in the tibia or chordoma in the sacrum
Introduction & Incidence: Rare - 0.5% of cancer deaths. 40% Malignant. Primary & Secondary/metastatic. Primary in Young. (Osteosarcoma) Secondary in the old. (Breast, Kidney, thyroid, lung, prostate) Marrow neoplasms (hemopoietic) myeloma, leukemia, lymphoma etc.
PRIMARY TUMORS OF BONE Bone-producing tumors Osteoma, osteoid osteoma, osteoblastoma Osteosarcoma* Cartilage-producing tumors Osteochondroma, chondroma (enchondroma) chondromyxoid fibroma chondroblastoma Chondrosarcoma* Miscellaneous tumors Ewings sarcoma* Giant cell tumor of bone Tumour-like conditions of bone Bone cysts Simple bone cyst Aneurysmal bone cyst Fibrous-osseous lesions Fibrous dysplasia Eosinophilic granuloma (Langerhans histiocytosis) Osteochondroma - ?hamartoma Approach Clinical X ray Bone scanning Patology : aspiration biopsy , open biopsy Radiology / x-ray Clues by Appearance of Lesion Clues by Location of Lesion Clues by Density of Lesion Other Clues Bone scanning
Clues by Appearance of Lesion Patterns of Bone Destruction Periosteal Reactions Tumor Matrix Expansile Lesions of Bone Clues by Appearance of Lesion Patterns of Bone Destruction Geographic Moth-eaten Permeative Geographic Bone Destruction Destructive lesion with sharply defined border Implies a less- aggressive, more slow- growing, benign process Narrow transition zone Geographic Bone Destruction Examples: Non-ossifying fibroma Chondromyxoid fibroma Eosinophilic granuloma Moth-eaten Bone Destruction Areas of destruction with ragged borders Implies more rapid growth Probably a malignancy
Permeative Bone Destruction Ill-defined lesion with multiple worm-holes Spreads through marrow space Wide transition zone Implies an aggressive malignancy Round-cell lesions Patterns of Bone Destruction Permeative
Tumor Matrix Osteoblastic Fluffy, cotton-like or cloud-like densities as Osteosarcoma Cartilaginous Comma-shaped, punctate, annular, popcorn- like as Enchondroma, chondrosarcoma, chondromyxoid fibroma Tumor Matrix Osteoblastic Cartilaginous Chondrosarcoma Osteochondroma: Expansile Lesions of Bone Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Multiple myeloma Metastasis Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Osteolytic Metastasis: Breast ca Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Renal cell carcinoma Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Multiple myeloma Mets Brown tumor Enchondroma Aneurysmal bone cyst Fibrous dysplasia Expansile Lesions of Bone Clues by Location of Lesion In the Transverse Plane In the Longitudinal Plane Characteristic Locations by tumors Characteristic Tumors by Body Site Pelvic Lesions Expansile Rib Lesions Lesions of the Spine In the Transverse Plane . . . In the longitudinal Plane Epiphyseal GCT, chondroblastoma
Diaphyseal Round cell lesions, ABC, enchondroma Characteristic Locations Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Epiphyses Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior Characteristic Locations Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Epiphyses Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Epiphyses Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior Characteristic Locations Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Epiphyses Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior Characteristic Locations Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Epiphyses Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior Characteristic Locations Simple bone cyst Proximal humerus Chondroblastoma Epiphyses Giant Cell tumor Epiphyses Adamantinoma Tibia Chordoma Sacrum, clivus Osteoblastoma Spine, posterior Characteristic Locations Clues by Density of Lesion Sclerotic Cortical Lesions Lytic Lesions in Children Lytic Lesions in Adults Blastic Lesions in Children Blastic Lesions in Adults Sclerotic Cortical Lesions Osteoid osteoma Brodies abscess Sclerotic Cortical Lesions Osteoid osteoma Brodies abscess Lytic Lesions in Children Eosinophilic granuloma Leukemia Lytic Lesions in Children Eosinophilic granuloma
Leukemia Lytic Lesions in Adults Metastatic lesions Lung Renal Thyroid Multiple myeloma Primary bone tumor Metastatic thyroid carcinoma Lytic Lesions in Adults Metastatic lesions Lung Renal Thyroid Multiple myeloma Primary bone tumor Lytic Lesions in Adults Metastatic lesions Lung Renal Thyroid Multiple myeloma Primary bone tumor Chondrosarcoma Blastic Lesions in Children Lymphoma Blastic Lesions in Adults Metastatic disease Breast female Prostate male Lymphoma Pagets disease Fluorosis Prostatic Ca. Blastic Lesions in Adults Metastatic disease Breast female Prostate male Lymphoma Pagets disease Fluorosis Blastic Lesions in Adults Metastatic disease Breast female Prostate male Lymphoma Pagets disease Fluorosis Blastic Lesions in Adults Metastatic disease Breast female Prostate male Lymphoma Pagets disease Fluorosis Other Clues
Soft Tissue Extension Benign vs. Malignant Soft Tissue Extension Usually implies malignancy More likely to form discrete soft tissue mass Benign conditions with soft tissue extension Osteomyelitis Usually infiltration of fat lymphoma Soft Tissue Extension Benign vs. Malignant