pattern of bone destruction
Post on 16-Nov-2014
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Pattern of Bone Destruction GEOGRAPHIC BONE DESTRUCTION
Cause:(a) slow-growing usually benign tumor(b)rarely malignant: plasma cell myeloma, metastasis(c) infection: granulomatous osteomyelitis
well-defined smooth / irregular margin
short zone of transition
MOTH-EATEN BONE DESTRUCTION
Cause:(a) rapidly growing malignant bone tumor(b) osteomyelitis
less well defined / demarcated lesional margin
longer zone of transition
mnemonic:H LEMMONo Histiocytosis Xo Lymphomao Ewing sarcomao Metastasiso Multiple myelomao Osteomyelitiso Neuroblastoma
PERMEATIVE BONE DESTRUCTION
Cause:aggressive bone tumor with rapid growth potential (eg, Ewing sarcoma)
poorly demarcated lesion imperceptibly merging with uninvolved bone
long zone of transition
Size, Shape, and Margin of Bone Lesion
Primary malignant tumors are larger than benign tumors
elongated lesion (= greatest diameter of >1.5 times the least diameter): Ewing sarcoma, histiocytic lymphoma, chondrosarcoma, angiosarcoma
sclerotic margin (= reaction of host tissue to tumor)
Tumor Position in Transverse Plane CENTRAL MEDULLARY LESION
o Enchondromao Solitary bone cyst
ECCENTRIC MEDULLARY LESION o Giant cell tumoro Osteogenic sarcoma, chondrosarcoma, fibrosarcomao Chondromyxoid fibroma
CORTICAL LESION o Nonossifying fibromao Osteoid osteoma
PERIOSTEAL / JUXTACORTICAL LESION o Juxtacortical chondroma / osteosarcomao Osteochondromao Parosteal osteogenic sarcoma
Tumor Position in Longitudinal Plane EPIPHYSEAL LESION
o Chondroblastoma (prior to closure of growth plate)o Intraosseous ganglion, subchondral cysto Giant cell tumor (originating in metaphysis)o Clear cell chondrosarcomao Fibrous dysplasiao Abscess
mnemonic:CAGGIEo Chondroblastomao Aneurysmal bone cysto Giant cell tumoro Geodeo Infectiono Eosinophilic granuloma
[after 40 years of age throw out “CEA†and insert metastases / myeloma]
METAPHYSEAL LESION o Nonossifying fibroma (close to growth plate)o Chondromyxoid fibroma (abutting growth plate)o Solitary bone cysto Osteochondromao Brodie abscesso Osteogenic sarcoma, chondrosarcoma
DIAPHYSEAL LESION o Round cell tumor (eg, Ewing sarcoma)o Nonossifying fibromao Solitary bone cysto Aneurysmal bone cysto Enchondromao Osteoblastomao Fibrous dysplasia
mnemonic:FEMALEo Fibrous dysplasiao Eosinophilic granulomao Metastasiso Adamantinoma
o Leukemia, Lymphomao Ewing sarcoma
Tumors Localizing to Hematopoietic Marrow Metastases Plasma cell myeloma Ewing sarcoma Histiocytic lymphoma
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