ABSTRACT
<p><b>OBJECTIVE</b>To study the radiologic and pathologic features of primary intermediate hemangioendothelioma of the bone.</p><p><b>METHODS</b>Five cases of primary intermediate hemangioendothelioma of bone encountered in the past three years were enrolled into the study. The clinical, radiologic, pathologic and immunohistochemical features of the tumors were reviewed.</p><p><b>RESULTS</b>The patients included 3 children with Kaposiform hemangioendothelioma and 2 elderly with retiform hemangioendothelioma. Four of the cases affected long bones and the remaining case affected the clavicle. One case showed multifocal involvement of the humerus. Radiologically, the tumors showed borderline to low-grade bony destruction, with various degrees of cortical defect. Intralesional or perilesional bone formation was demonstrated in 4 cases and radial spicules were seen in 1 case. The histopathologic features of primary intermediate hemangioendothelioma of bone were similar to those of soft tissue, except for the presence of reactive bone formation. Immunohistochemically, the tumor cells were positive for CD31 (5/5), CD34 (5/5), vimentin (5/5) and smooth muscle actin (3/5) but negative for cytokeratin and epithelial membrane antigen.</p><p><b>CONCLUSIONS</b>Primary intermediate hemangioendothelioma of bone is a distinct entity and similar histologic classification applies as in its soft tissue counterparts. Comparison of the biologic behavior requires long-term follow-up studies.</p>
Subject(s)
Child , Female , Humans , Infant , Male , Middle Aged , Actins , Metabolism , Antigens, CD34 , Metabolism , Bone Neoplasms , Diagnostic Imaging , Metabolism , Pathology , Clavicle , Pathology , Diagnosis, Differential , Femur , Pathology , Hemangioendothelioma , Diagnostic Imaging , Metabolism , Pathology , Hemangiosarcoma , Pathology , Humerus , Pathology , Immunohistochemistry , Kasabach-Merritt Syndrome , Diagnostic Imaging , Metabolism , Pathology , Platelet Endothelial Cell Adhesion Molecule-1 , Metabolism , Radiography , Sarcoma, Kaposi , Diagnostic Imaging , Metabolism , Pathology , Vimentin , MetabolismABSTRACT
0.05).However,the specificity of axial MRI diagnosis was higher than that of the sagittal one. Conclusion MRI axial T2WI may provide important information for the diagnosis of patients with ACL injury.
ABSTRACT
Objective To analyze the value of MRI in the diagnosis of giant cell tumor of tendon sheath(GCTTS). MethodsThe MR images of 21 GCTTS cases including 3 cases of recurrences were retrospectively evaluated.All were confirmed giant cell tumor of tendon sheath by surgery and pathology.All the patiens were examined by MRI,and 19 received contrast enhanced MRI.The characteristics of MRI presentations were explored.Results Of the 21 cases,17 were in diffuse form and 4 in localized form.On T1WI,the signal intensities of the giant cell tumor of tendon sheath almost equalled to those of skeletal muscle in 18 cases and were slightly lower than those of skeletal muscle in 3 cases.On T2WI,the signal intensities tended to range between those of skeletal muscle and fat in 7 cases,almost equalled to those of skeletal muscle in 12 cases,and were slightly lower than those of skeletal muscle in 2 cases.Of the 19 cases with gadolinium-enhanced images,17 showed inhomogeneous enhancement and 2 homogeneous enhancement,and all were observed with a fat suppression sequence on T1WI. Conclusion MRI is able to depict the characteristic internal signal of giant cell tumor of tendon sheath,which is a valuable for diagnosis,treatment and follow-up.
ABSTRACT
<p><b>OBJECTIVE</b>To study the clinical, pathologic and radiologic features of chondroblastoma occurring in sites other than epiphysis and apophysis of long bones, and to investigate possible reasons for misdiagnosis.</p><p><b>METHODS</b>The clinical, pathologic and radiologic data of 18 chondroblastoma cases occurring in atypical sites were collected from 5 major hospitals in Shanghai during the past 12 years. S-100 immunostaining was performed to confirm the cartilaginous differentiation of the tumor cells.</p><p><b>RESULTS</b>Chondroblastoma occurred in small bones of feet in 10 of the 18 cases (55.6%) studied, being commonest in the talus and calcaneus bones. Mean age of the patients was 27.8 years, with 55.6% over 25 years of age. Radiologic examination revealed expansive, multilocular and well-demarcated radiolucent lesions in most cases. There was local cortical destruction in 5 cases (28%) and soft tissue infiltration in 1 case. In 10 cases (55.6%), the tumor was associated with aneurismal bone cyst or simple bone cyst formation. None of the cases studied was accurately diagnosed clinically before the operation. In 2 cases, the pathology was also misdiagnosed, often being diagnosed as aneurismal bone cyst or giant cell tumor.</p><p><b>CONCLUSIONS</b>Chondroblastoma occurring in atypical sites are often associated with atypical age, radiologic features and pathologic findings at presentation. Thorough understanding of the potential pitfalls is essential in order to avoid misdiagnosis.</p>
Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Bone Cysts, Aneurysmal , Diagnosis , Diagnostic Imaging , Pathology , Bone Diseases , Diagnosis , Diagnostic Imaging , Pathology , Bone Neoplasms , Diagnosis , Diagnostic Imaging , Pathology , Calcaneus , Chondroblastoma , Diagnosis , Diagnostic Imaging , Pathology , Diagnostic Errors , Giant Cell Tumor of Bone , Diagnostic Imaging , Pathology , Radiography , TalusABSTRACT
Objective To review the radiological findings of the chondroblastomas on the atypical sites of the skeleton system.Methods We collected the total image data of 13 patients who were pathologically confirmed the chondroblastomas on the atypical sites of the bone system from the department of orthopedics in shanghai No.6 hospital since 1991.Among all the patients,11 cases were male and others were female.The range of age was 10—50 years and the average age of the patients was 26.2 years old.A retrospective analysis of radiological signs from different diagnostic imaging modalities was made.Results X-ray examination was underdone on all case.On the plain X-ray films,all cases were lytic lesions.The radiolucent lesions were seen in 10 cases,mixed density in 3 cases.10 cases manifested expansible contour. Eleven cases were performed computed tomography(CT)examination.On CT,there were visible calcification in 8 cases,sclerotic margin in 10 cases,internal septation in 4 cases.Soft masses could be seen in 3 cases.Magnetic resonance examination(MRI)was done on 5 cases.On T_1 weighted images(T_1WI), the lesion was hypo and intermediate intense signal and heterogeneous hyperintense signal on T_2 weighed images(T_2WI).The fluid-fluid level and solid-fluid level were seen on 3 cases.On one post-contrast examination,the moderate enhancement was seen on the solid portion of the tumor and however,the obvious enhancement on the septation within the lesion.Conclusion The radiological findings of the chondroblastomas on the atypical sites of the bone system were not suggestive.However,it could display some particular signs of the chondroid tumors such as calcification,septation,etc.To effectively apply the different imaging modalities can be helpful to make a right diagnosis before the operation.