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Diseases of Infancy and Childhood
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Langerhans cell histiocytosis (LCH) is an inflammatory neoplasia that primarily affects children. It has a peak incidence in patients aged 1–3 years and is most common in Caucasian boys. LCH may appear as a single cutaneous lesion or can affect many body systems, such as the skin, bone, lymph nodes, liver, lung, spleen, brain, pituitary gland, and bone marrow. LCH classically presents with a cutaneous eruption or painful osteolytic lesion. Systemic symptoms may also be present.
Bone
Published in Joseph Kovi, Hung Dinh Duong, Frozen Section In Surgical Pathology: An Atlas, 2019
A 45-year-old man was admitted to the hospital complaining of nagging pain in his right thigh. On examination, his right thigh appeared moderately swollen and tender. Roentgen-ographically, an osteolytic lesion was visualized in the proximal end of the diaphysis of the right femur. Multiple small lytic areas were noted in the bone with no discernible periosteal reaction. A provisional clinical diagnosis of primary reticulum cell sarcoma was made, and the bone biopsied. Microscopically, a highly cellular tumor was found. The tumor cells were moderately large and the nuclei varied slightly in shape and size. The nuclei were often indented or lobulated and possessed rather prominent nucleoli. Quite a few mitotic figures could be recognized. The neoplastic cells had distinct cytoplasmic borders (Figure 72).
Tumours
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Jonathan Stevenson, Michael Parry
Radiographically, an aggressive, permeative, poorly defined osteolytic lesion with cortical destruction, periosteal reaction and large, radiolucent soft-tissue mass may be found. Periosteal reaction is common in young patients with the lamellar ‘onion-skin’ appearance causing fusiform bone enlargement (Figure 9.29). This may mimic infection or eosinophilic granuloma in young patients; subtle bone involvement with a large soft-tissue mass could mimic primary bone lymphoma in older patients.
Multifocal and hormone-dependent epithelioid hemangioendothelioma with osteolysis of the second cervical vertebral body: report of an unprecedented surgical approach by using autologous bone graft
Published in British Journal of Neurosurgery, 2023
Hanno M. Witte, Armin Riecke, Thomas Mayer, Carsten Hackenbroch, Konrad Steinestel, Niklas Gebauer, Dirk Puckhaber, René Mathieu, Uwe Max Mauer, Chris Schulz
Two years later, during her first pregnancy, the patient reported severe neck pain which progressively worsened during her postpartum hospital stay. A clinical neurological examination did not reveal radicular signs or symptoms. The sensory and motor functions of all four extremities were normal. Magnetic resonance imaging (MRI) of the cervical spine was conducted and demonstrated an osteolytic lesion at C2 (Figure 2). An association with the glomangioma of the maxillary sinus that had been extirpated two years before was not apparent at this time point. Since a malignant condition was suspected, MRI of the entire spine was performed and revealed further osteolytic foci at the fourth cervical vertebral body (C4) and at the first, fourth, seventh and ninth thoracic vertebral bodies (T1, T4, T7 and T9), which, however, were smaller and did not compromise stability (Figure 3). Positron emission tomography-computed tomography (PET-CT) of the entire body was carried out in order to localize a potentially malignant primary tumor. PET-CT findings, however, provided evidence of increased metabolic activity only at C2. This diagnostic modality did not demonstrate any extraosseous foci.
Primary leiomyosarcoma of cervical spine invading the vertebra without obvious osteoclasia: Case report and literature review
Published in The Journal of Spinal Cord Medicine, 2022
Han Sun, Min Zhuang, Dong Cheng, Chenlei Zhu, Zhiwei Liu, Xubin Qiu
Because of its aggressive nature, leiomyosarcoma adjacent to the bone is usually combined with extensive infiltration of the trabecular bone. These tumors are usually initially diagnosed with X-ray or CT, the principal feature of which consists in a solitary osteolytic lesion with indistinct margins and cortical destruction with no presence of bone matrix production, with about 15% patients presenting with a pathological fracture. All the three previously reported cases reported the osteolytic lesion of vertebra: one reported the compression fracture of the vertebra,2 one reported the infiltrative lesion in the left C2 region,3 and one reported the bone erosion and infiltration within the posterior elements of C4.1 However, in our case no obvious bone destruction could be found in X-ray, CT scan, PET-CT, or even under direct vision, which disturbed our primary diagnosis of the tumor at the initial stage. We inferred the reason could be that the tumor was in its early stage, who just invaded to the vertebra without destructing the structure of bone.
Effect of metastatic lesion size and location on the load-bearing capacity of vertebrae using an optimized ash density-modulus equation
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Sebastian Saldarriaga, Simon Jimenez Cataño, Asghar Rezaei, Hugo Giambini
Osteolytic metastases are characterized by significant bone disruption due to increased osteoclastic activity, and are more common than osteoblastic metastases (Smith 2011). Osteolytic metastases create lesions or voids in the vertebrae and/or changes the bone material to softer properties (Whyne et al. 2000). Osteolytic lesion size has been considered as one of the most significant risk factors leading to vertebral fracture (Taneichi et al. 1997; Patel and DeGroot 2001). It is important to note that the location of the lesion within the vertebral body has not been highlighted in detail in previous studies. This might have been due to the small patient cohorts evaluated and the several explanatory variables related to fracture risk (Taneichi et al. 1997; Shah et al. 2003). Other biomechanical studies have also addressed the importance of tumor locations within vertebral bodies. Tschirhart et al. (2004) implemented a generic, non-subject specific FEA model to investigate the effect of tumor location within vertebral bodies showing vertebral bulge to vary significantly depending on the location of the lesion within vertebral bodies. Krishnaney et al. (2004) showed the importance of tumor location within a vertebral body stating destruction in the axial plane could lead to gross instability, while similar bone destruction in the sagittal plane would not have a significant effect.