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1.
The malignant vascular tumors of bone represent an uncommon diverse group of tumors with widely variable clinical and radiographic
presentations. Although the radiographic imaging features of the lytic osseous lesions typically seen with this group of tumors
are relatively nonspecific, the propensity to develop multifocal disease in an anatomic region is a feature that can be helpful
in suggesting the diagnosis of a vascular tumor. The differential diagnosis varies according to the age of the patient and
presence of solitary or multifocal disease. The histologic features are variable and range from tumors with vasoformative
features to those that mimic mesenchymal neoplasm or metastatic carcinoma. Familiarity with the radiographic and pathologic
spectrum of disease is essential for making an accurate diagnosis in this diverse group of neoplasms. This paper will provide
a review of the nomenclature for the malignant vascular tumors of bone and discuss the radiographic and pathologic differential
diagnosis.
Received: 17 December 1999 Revision requested: 8 February 2000 Revision received: 19 May 2000 Accepted: 9 June 2000 相似文献
2.
Desmoplastic fibroma of bone: MRI features 总被引:5,自引:0,他引:5
Vanhoenacker FM Hauben E De Beuckeleer LH Willemen D Van Marck E De Schepper AM 《Skeletal radiology》2000,29(3):171-175
Desmoplastic fibroma of bone is a very rare benign tumor, which may be locally aggressive. In contrast to the well-documented
radiological appearance, the literature on MR imaging features of this tumor is scarce. The MR imaging characteristics in
our case are compared to those previously reported. Although there is a considerable overlap in the MR imaging features with
other bone tumors, an interesting MR feature of desmoplastic fibroma is the presence of low to intermediate signal intensity
foci on T2-weighted images, which radiographically does not correspond to calcifications. This feature may help narrow the
differential diagnosis.
Received: 24 May 1999 Revision requested: 30 June 1999 Revision received: 8 October 1999 Accepted: 14 October 1999 相似文献
3.
Chondromyxoid fibroma is an unusual, benign tumor of cartilaginous origin and represents less than 1% of all primary bone
tumors. It usually involves the long bones around the knee joint or the flat bones of the pelvis or ribs. Soft tissue extension
is also thought to be rare in these lesions. They are usually eccentrically located in the metaphyses of the long bones and
centrally in the flat bones. The radiographic appearances are characteristically those of a single, lytic lesion with lobulated
margins, septations, cortical expansion and a sclerotic rim. Histologically, they display a lobulated pattern with spindle-shaped
cells lying within a myxoid matrix with areas of hyaline cartilage. The differential diagnosis includes giant cell tumor,
chondroblastoma or enchondroma as well as chondrosarcoma. The rarity of these lesions may render the diagnosis difficult to
make, especially when the lesion involves an unusual site such as the acromium.
Received: 21 June 1999 Revision requested: 27 September 1999 Revision received: 27 October 1999 Accepted: 28 October 1999 相似文献
4.
Intraosseous schwannoma (neurilemmoma) is an extremely rare, benign neoplasm, constituting less than 0.2% of primary bone
tumors. It infrequently involves the bones of the hand. We present a case of intraosseous neurilemmoma of the metacarpal.
Received: 26 July 1999 Revision requested: 16 August 1999 Revision received: 16 September 1999 Accepted: 4 October 1999 相似文献
5.
Tumors of peripheral nerves: correlation of symptoms, clinical signs, imaging features, and histologic diagnosis 总被引:2,自引:0,他引:2
Akira Ogose Tetsuo Hotta Tetsuro Morita Soichiro Yamamura Noboru Hosaka Hiroto Kobayashi Yasuharu Hirata 《Skeletal radiology》1999,28(4):183-188
Objective. To distinguish between benign and malignant tumors in the peripheral nerves. Design and patients. The clinical, imaging and histologic findings of 99 benign and 16 malignant tumors in the peripheral nerves were reviewed
retrospectively. Results. Preoperative motor weakness was observed in only six of 99 benign tumors and was mild, while slight to severe motor weakness
was present in 15 of 16 malignant lesions. Pain at rest was present in five of 99 benign tumors and in 15 of 16 malignant
tumors. All benign lesions showed a smooth tumoral margin, while half the malignant lesions showed an invasive margin on CT
or MRI. Thirteen of 28 benign lesions on CT and nine of 23 on MRI showed round to geographic central enhancement, but this
pattern was not seen in malignant lesions. Conclusion. Absence of severe motor weakness and a central enhancement pattern strongly suggest a benign nature, while severe rest pain
and invasive tumor margin suggest malignant lesions in peripheral nerve tumors.
Received: 30 July 1998 Revision requested: 30 October 1998 Revision received: 30 November 1998 Accepted: 12 January 1999 相似文献
6.
Marginal erosive discovertebral ”Romanus” lesions in ankylosing spondylitis demonstrated by contrast enhanced Gd-DTPA magnetic resonance imaging 总被引:5,自引:0,他引:5
Objective. To assess the value of Gd-DTPA magnetic resonance (MR) imaging in the demonstration of marginal destructive discovertebral
Romanus lesions in ankylosing spondylitis.
Design and patients. A prospective study of Gd-DTPA MR imaging was performed in 39 patients with a clinical diagnosis of ankylosing spondylitis
and typical Romanus lesions seen on radiographs of the thoracolumbar spine. MR morphological appearances and signal intensity
changes at the discovertebral junctions were analysed and compared with the radiographic findings.
Results. Ninety-nine discovertebral junctions with Romanus lesions showed low signal intensity on T1-weighted and high signal on
T2-weighted and T1-weighted postcontrast images at the vertebral corners consistent with oedematous hyperaemic inflammatory
tissue. There were nine discovertebral junctions with similar MR findings but normal radiographs. Fifty-three discovertebral
junctions showed syndesmophyte formation with increased signal intensity on both T1- and T2-weighted images with no contrast
enhancement. Sixty-five discovertebral junctions showed a mixture of radiographic features and varied high and low signal
changes at the vertebral rim on MR imaging with rims of enhancement in the vertebral body following contrast administration.
Conclusion. Gd-DTPA MR imaging demonstrates a variable signal pattern and degree of contrast enhancement which may reflect the evolutionary
stages of discovertebral enthesitis in ankylosing spondylitis. MR imaging may identify early erosive changes in radiographically
normal vertebra. The role of MR imaging needs further investigation.
Received: 6 April 1998 Revision requested: 7 May 1998 Revision received: 26 October 1999 Accepted: 27 October 1999 相似文献
7.
We present a case of sarcomatoid renal cell carcinoma with multiple sclerotic skeletal metastatic lesions. Renal cell carcinoma
is frequently metastatic at presentation, with a high incidence of skeletal involvement, classically described as osteolytic.
However, sclerotic or osteoblastic metastatic skeletal lesions from renal cell carcinoma are rare, with only two previous
reports identified in the literature, neither of which involved the sarcomatoid variant of renal cell carcinoma. In our case
the sclerotic metastases were characterized by bone scan, computed tomography (CT), magnetic resonance imaging (MRI), and
histologic analysis.
Received: 8 April 1999 Revision requested: 27 May 1999 Revision received: 24 June 1999 Accepted: 29 June 1999 相似文献
8.
MR imaging of inflammatory joint diseases of the foot and ankle 总被引:1,自引:1,他引:0
Pain affecting the foot and ankle is a common complaint frequently attributable to inflammatory joint diseases. Although conventional
radiography is regarded as the initial step in the diagnostic investigation, MR imaging may contribute to further evaluation
of these patients due to the direct visualization of the inflammatory soft tissue formed in the disease and its effects on
bone, cartilage and para-articular structures. The high spatial resolution of MR imaging combined with tissue characterization
often allows initial detection of inflammatory joint abnormalities at a stage that precedes radiographic evaluation. The typical
MR appearance of certain inflammatory joint disorders may be helpful in narrowing the wide differential diagnosis. Furthermore,
MR imaging can be used for an exact assessment of the extent of the disorder as well as its complications. Accurate diagnostic
information can guide the clinician in further diagnostic tests and implementation of proper therapeutic treatment.
Received: 12 November 1998 Revision requested: 12 February, 10 June 1999 Revision received: 14 September 1999 Accepted: 20
September 1999 相似文献
9.
Bush CH 《Skeletal radiology》2000,29(1):1-9
Hematomas in the extremities can present clinically as a soft tissue mass. Hematomas can usually be distinguished from neoplasia
on MR by the signal patterns of hemoglobin breakdown products, which are dependent on the chemical bonding and oxidation state
of hemoglobin iron. Beginning with a discussion of relevant atomic electronic structure, this review will examine how oxyhemoglobin,
deoxyhemoglobin, methemoglobin, and hemosiderin, the principal iron compounds occurring in the various stages of a hematoma,
affect its appearance on MRI.
Received: 26 August 1999 Revision requested: 6 October 1999 Revision received: 27 October 1999 Accepted: 27 October 1999 相似文献
10.
Leclair A Gangi A Lacaze F Javier RM Bonidan O Kempf JF Bonnomet F Limbach FX Kuntz JL Dietmann JL Sibilia J 《Skeletal radiology》2000,29(5):275-278
Percutaneous injection of methylmethacrylate is now increasingly employed to treat bone lesions, both malignant and benign.
However, the risks of this procedure are still to be fully established. In this report, we describe a case of rapid chondrolysis
appearing after the intra-articular leakage of cement during injection of an acetabular subchondral cyst, resulting in hip
replacement. Although the mechanism of such chondrolysis is unknown, this event suggests a chondrolytic effect of the acrylic
cement. Thus, it is essential to systematically search for the presence of an intra-articular passage before injecting bone
cement into a peri-articular cyst. This unusual complication highlights the need for rigorous evaluation of the benefits and
risks of percutaneous injection of acrylic cement in the treatment of benign lesions, especially close to an articulation.
Received: 30 September 1999 Revision requested: 1 December 1999 Revision received: 27 December 1999 Accepted: 27 December
1999 相似文献
11.
Elastofibroma of the neck 总被引:1,自引:0,他引:1
Elastofibromas are benign lesions of the chest wall. We describe the first reported case of elastofibroma in the neck. Imaging
features as well as location of the lesion were atypical. On computed tomography and magnetic resonance imaging the lesion
contained a marked preponderance of fat, because the lesion arose within fat.
Received: 12 November 1998 Revision requested: 18 November 1998 Revision received: 16 August 1999 Accepted: 24 August 1999 相似文献
12.
Giant distal humeral geode 总被引:2,自引:0,他引:2
We describe the imaging features of a giant geode of the distal humerus in a patient with rheumatoid arthritis, which presented
initially as a pathological fracture. The value of magnetic resonance imaging in establishing this diagnosis is emphasized.
Received: 8 July 1999 Revision requested: 24 August 1999 Revision received: 25 October 1999 Accepted: 26 October 1999 相似文献
13.
Fujimoto H Nishimura G Motoori K Ueda T Tanaka Y Tsumurai Y Matsubara T Nosaka K 《Skeletal radiology》2000,29(5):286-288
We report a case of a metastatic bone tumor that mimicked spontaneous osteonecrosis of the medial condyle of the femur on
magnetic resonance imaging.
Received: 5 October 1999 Revision requested: 11 November 1999 Revision received: 10 January 2000 Accepted: 17 January 2000 相似文献
14.
Primary hyperparathyroidism is rarely caused by carcinoma. We report a patient who manifested many of the clinical and radiographic
features of the disease. When encountering symptomatic hypercalcemia with or without a palpable neck mass, carcinoma should
be considered in the differential diagnosis. Patient survival depends on an aggressive surgical approach to the primary lesion
and recurrent disease.
Received: 27 May 1999 Revision requested: 28 June 1999 Revision received: 22 September 1999 Accepted: 27 September 1999 相似文献
15.
We report a paediatric case of non-Hodgkin's lymphoma with secondary breast involvement. On US exam there were bilateral
multiple well-defined masses. Contrast-enhanced thorax CT demonstrated the breast lesions as well as enhancing masses. To
our knowledge, this type of lymphomatous breast involvement in a child is rare and its CT features are very rarely demonstrated.
Received: 16 October 1998; Revision received: 21 April 1999; Accepted: 28 May 1999 相似文献
16.
Epithelioid hemangioma of bone 总被引:2,自引:0,他引:2
Although no specific radiographic appearance has emerged to date for the epithelioid subtype of hemangioma, these lesions
most typically exhibit well-defined osteolysis. Other relatively common features include surrounding sclerosis, cortical expansion
and cortical destruction. We present a case of epithelioid hemangioma of the spine with an unusual radiological appearance
which to our knowledge has not previously been reported: diffuse sclerosis of the involved vertebral body. The diffuse sclerosis
seen in this case resembles the osteosclerotic process seen not only in benign entities such as subacute and chronic osteomyelitis,
but also in malignant lesions such as osteoblastic metastatic disease and lymphoma.
Received: 28 July 2000 Revision requested: 8 September 2000 Revision received: 5 December 2000 Accepted: 6 December 2000 相似文献
17.
A 43-year-old man with a large ancient schwannoma of the pelvis, presenting with varicose veins, is reported. Ancient schwannoma
(neurilemmoma) is a benign tumour of nerve sheath origin characterised histologically by features of severe degeneration and
which rarely can grow to a large size. Malignant transformation, though reported, is extremely rare.
Received: 17 September 1999 Revision requested: 13 October 1999 Revision received: 22 June 2000 Accepted: 28 June 2000 相似文献
18.
Nakazono T Kudo S Matsuo Y Matsubayashi R Ehara S Narisawa H Yonemitsu N 《Skeletal radiology》2000,29(7):413-416
Magnetic resonance (MR) imaging findings of two patients with Stewart-Treves syndrome are presented. MR imaging showed edematous
changes in the subcutaneous fat and skin masses that proved to be angiosarcomas. MR signal intensity of the tumor was low
compared with fat on T1-weighted images and intermediate and heterogeneous on T2-weighted images. In one patient, administration
of intravenous Gd-DTPA showed marked enhancement in the early phase, which persisted until the delayed phase. These finding
on dynamic MR imaging may reflect the abundant vascular spaces seen in these tumors.
Received: 20 August 1999 Revision requested: 28 October 2000 Revision received: 31 January 2000 Accepted: 8 February 2000 相似文献
19.
A recently proposed addition to fibrous tumors in soft tissue was first described as desmoplastic fibroblastoma and later
renamed collagenous fibroma. This tumor is clinically and morphologically distinct and benign. However, only a few series
have been reported, and the clinicopathologic features are not widely recognized. We present two cases of collagenous fibroma
of the arm. Both patients presented with an enlarging, well-circumscribed and mobile soft tissue mass. Magnetic resonance
imaging showed areas of low signal intensity on both T1- and T2-weighted sequences. Needle aspiration cytology revealed nondiagnostic
samples because of the low cellularity of the tumors. Each of the resected tumors was composed of low-cellular spindle- to
stellate-shaped cells in a fibrous matrix with clear margination. After the marginal excisions, no recurrences were observed.
Clinicians should be aware of this entity to prevent overtreatment, because imaging findings and cytologic features are similar
to those of desmoid tumor.
Received: 15 December 1999 Revision requested: 12 January 2000 Revision received: 31 March 2000 Accepted: 17 March 2000 相似文献
20.
A case of ossified leiomyoma of the deep soft tissues of the left thigh is presented. The radiographic appearance suggested
a low-grade chondrosarcoma. MRI of the lesion showed signal characteristics similar to muscle on both T1- and T2-weighted
spin echo sequences with linear areas of high signal intensity on T1-weighted images consistent with medullary fat in metaplastic
bone. Histopathological examination of the resected specimen revealed a benign ossified soft tissue leiomyoma.
Received: 23 December 1998 Revision requested: 31 January 1999 Revision received: 11 March 1999 Accepted: 16 March 1999 相似文献