| PART1 Retrospective anatysis of clinic in malignant bone tumor of pelvic bonesObjective:A retrospective analysis was made on the clinical data of 120 cases in malignant bone tumors of pelvic bones from 2005 to 2014. All cases were confirmed by operation or biopsy and pathology. Determine the pathological pattern,age,sex and location distribution and clinical feature of these malignant bone tumors, and to provide a reference to epidemiological investigation,imaging diagnosis and differential diagnosis.Materials and Methods:1. Object:From Jan.2005 to Dec.2014 120 malignant bone tumors were selected from the Nanfang PACS of the Southern medical university Nanfang hospital and Landwind PACS of Hongkong university-Shenzhen hospital. All cases were confirmed by operation or biopsy and pathology. According to the WHO(2013),most of pathological patterns were included in these cases.They included Haematopoietic neoplasm(plasmacytoma 39cases and non-Hodgkin lymphoma of bone 25 cases),Chondrogenic tumor(Chondrosarcoma 20 cases),Osteogenic tumor(osteosarcoma 13 cases and aggressive Osteoblastoma two cases), Miscellaneous tumor (Ewing sarcoma 11 cases and Undifferentiated high grade pleomorphic sarcoma of bone three cases),Fibrogenic tumor(Fibrosarcoma of bone two cases) and other malignant bone tumors(rhabdomyosarcoma, hemangiosarcoma and alveolar soft tissue sarcoma 1 case repectively).2. Research method120 cases in malignant bone tumors of pelvic bones from 2005 to 2014 were selected.Sorting and statisticsing the data of these 120 cases, determine the pathological pattern,age,sex and location distribution and clinical feature.Divided the age into groups 0-10,10-20,20-30,30-40,40-50,50-60,60-70,70-80.According to the WHO(2013), malignant bone tumors of pelvic bones including plasmacytoma, non-Hodgkin lymphoma of bone, Chondrosarcoma, osteosarcoma,aggressive Osteoblastoma,Ewing sarcoma 11 cases,Undifferentiated high grade pleomorphic sarcoma of bone,Fibrosarcoma of bon,rhabdomyosarcoma, hemangiosarcoma and alveolar soft tissue sarcoma.Tumor locations were divided into solitary and multiple lesion.According to the Enneking tumor partition allocation method,all the solitary cases were divided into solitary and multiple region.solitary region included â… , â…¡, â…¢ and â…£ region.Multiple regions included â… +â…¡,â… +â…£, â…¡+â…¢,â… +â…¡+â…£ and â… +â…¡+â…¢+â…£ regions.Clinical manifestations (symptoms and complaints) mainly for lesions corresponding parts of pain,discomfort and local palpable or other parts appear symptoms.RESULT1.The pathological types and incidenceAll 120 cases were confirmed by operation or biopsy and pathology.They included plasmacytoma 39cases(about 32.5%),non-Hodgkin lymphoma of bone 25 cases(about 20.83%),Chondrosarcoma 20 case(about 16.67%)),osteosarcoma 13 cases(about 10.83%),Ewing sarcoma 11 cases(about 9.17%),Undifferentiated high grade pleomorphic sarcoma of bone five cases(about 4.17%),aggressive Osteoblastoma and Fibrosarcoma of bone two casesrepectively(about 1.67%), rhabdomyosarcoma, hemangiosarcoma and alveolar soft tissue sarcoma 1 case repectively (about 0.83%).2.Sex and ageIt is common in males,with a male-to-female ratio of 1.4:1. The age range is between 10 and 78,median age was 40.8 years.There were 59 cases were less than 40 years(including plasmacytoma seven cases, non-Hodgkin lymphoma 14 cases, Chondrosarcoma eight cases,osteosarcoma 11 cases,Ewing sarcoma 11 cases and other Rare pathological patterns 4 cases) and 61 cases were more than 41 years(including plasmacytoma 32 cases, non-Hodgkin lymphoma 11 cases, Chondrosarcoma 12 cases,other Rare pathological patterns eight cases,Ewing sarcoma two cases and osteosarcoma one cases).3.LocationOf the 120 cases in pelvis bones there are solitary lesion 92 cases and multiple 28 cases.The locations were in solitary region 39 cases and multiple region 53 cases of the 92 cases.All the solitary lesions included â… region 15 cases, â…¡ region three cases,â…¢ region 16 cases and IV region 8 cases, â… +â…¡ regions 9 cases, â… +â…£ regions 12 cases,â…¡+â…¢ regions eight cases, â… +â…¡+â…£ regions 14 cases and â… +â…¡ +â…¢+â…£ regions 10 cases.4.Clinical manifestationThe symptoms of 28 multiple bone lesions were low back pain, discomfortable or hip joint activity limitation.In 92 cases of solitary lesion,the tumors involved the pericacetabular(â…¡ region) appearanced hip joint pain and activity limitation,the tumors involved the wing of ilium(â… region) were hips discomfortable and touch the obvious soft tissue mass,the tumors involoved the ilium near the sacral region(â…¢ region) appearaced Lumbosacral pain,and the tumors involoved the Superior and inferior ramus of pubis appearanced soft tissue mass.ConclusionThe sarcoma types that most commonly originate from the pelvis bones include plasmacytoma, non-Hodgkin lymphoma,Chondrosarcoma,osteosarcoma and Ewing sarcoma.Less common types include Undifferentiated high grade pleomorphic sarcoma of bone,Fibrosarcoma of bon,rhabdomyosarcoma, hemangiosarcoma and alveolar soft tissue sarcoma.The incidence of male is higher than female.Although the sarcoma of pelvis bones can occur in child and old people,but osteosarcoma is more common in child,plasmacytoma and chondrosarcoma are more common in old people.The age range of Ewing sarcoma and non-Hodgkin lymphoma in pelvic bones are much wide.Of the sarcoma in pelvis bones,the solitary lesion is much more than multiple lesion.The multiple bone sarcoma are common in plasmacytoma and non-Hodgkin lymphoma Of the solitary lesions,Chondrosarcoma and Ewing sarcoma often involve region â…¢,Osteosarcoma often involve region â… +â…¡+â…£,and plasmacytoma and non-Hodgkin lymphoma often involve region â… and â…£.The clinical presentation of pelvis bone sarcoma is variable and nonspecific.Occasionally the plasmacytoma and non-Hodgkin lymphoma are presenting low back pain, discomfortable or discovered incidentally on imaging studies.Pain,swelling,and hip joint pain activity limitation are common presentations in different pathological types.PART2 Clinical characteristics and imaging feature of Haematopoietic neoplasm in pelvic bonesObjective:A retrospective analysis was made on the clinical characteristics and imaging features of 64 cases in haematopoietic neoplasm(including plasmacytoma 39 cases and non-Hodgkin lymphoma 25 cases) in pelvic bones from 2005 to 2014. All cases were confirmed by operation or biopsy and pathology. Comparing the imaging appearances of non-haematopoietic neoplasm,and getting the imaging feature of haematopoietic neoplasm. The object is to improving the diagnosis and differential diagnosis of haematopoietic neoplasm.Materials and Methods:1.Object:From Jan.2005 to Dec.2014 120 malignant bone tumors were selected from the Nanfang PACS of the Southern medical university Nanfang hospital and Landwind PACS of Hongkong university-Shenzhen hospital. All cases are confirmed by operation or biopsy and pathology. Of the 120 cases in pelvis bones,there are haematopoietic neoplasms 64 cases(including plasmacytoma 39 cases and non-Hodgkin lymphoma 25 cases) and non-haematopoietic neoplasms 56 cases.There were 38 cases are solitary lesion disease,including plasmacytoma 18 cases and non-Hodgkin lymphoma 20 cases.Of the plasmacytoma 18 cases,16 cases had X-ray examination,8 cases had CT scan,and 14 cases had MRI examination.Of the non-Hodgkin lymphoma 20 cases,19 cases had X-ray examination,8 cases had CT scan,and 13 cases had MRI examination.2. Research methodX-ray examination:SIEMENS Aristos MX digital X-ray machine underwent frontal and lateral X-ray films when exam hip joint and pelvis. CT examination:GE Lightspeed 16 multi-detector helical CT and SIEMENS SOMATOM Definition AS 64 multi-detector helical CT,non-ionic contract agent was iohexol(300mgl/ml). MRI examination:GE 3.0T MRI scanner and SIEMENS 1.5T MRI machine. Choose the body coils according to lesions. Contract materials were Gd-DTPA.The images were diagnosis by three experienced doctor form radiology department. The data were blinded. If there were any opinions differ in sign observed,the verdict given by the superior doctor. The clinical manifestation include age,sex and location. The observation of imaging include bony destruction, pathologic fracture and the signa of the tumor in MRI examination.RESULT1. Sex and ageIt is common in males,with a male-to-female ratio of 1.46:1. The age range is between 10 and 78,median age was 40.8 years.There were five cases were 11 to 20 years(all cases are non-Hodgkin lymphoma),seven cases were 21 to 30 years(including non-Hodgkin lymphoma two case and plasmacytoma five cases),nine cases were 31-40(including non-Hodgkin lymphoma four case and plasmacytoma five cases),13 cases were 41 to 50 years (including non-Hodgkin lymphoma two case and plasmacytoma 11 cases),15 cases were 51 to 60 years(including non-Hodgkin lymphoma five case and plasmacytoma 10 cases),10 cases were 61 to 70 years (including non-Hodgkin lymphoma one case and plasmacytoma nine cases),and five cases were 71 to 80 years(including non-Hodgkin lymphoma three case and plasmacytoma two cases).2. LocationOf the 64 cases haematopoietic neoplasms in pelvis bones there were solitary lesion 38 cases and multiple 26 cases.The locations were in solitary region 11 cases and multiple region 27 cases of the 64 cases.All the solitary lesion cases included I region three cases, II region two cases,â…¢ region four cases and IV region two cases, â… +â…¡ regions six cases, â… +â…£ regions 11 cases, â…¡+â…¢ regions four cases, â… +â…¡+ â…£ regions three cases and â… +â…¡+â…¢+â…£ regions two cases.Region â… +â…¡ were more common involved in haematopoietic neoplasms.3. Bone destructionOf the 38 cases solitary lesion haematopoietic neoplasms,there were all Osteolytic bone destruction(including permeative destruction 16 cases and moth-eaten patteren of destruction 22 cases).Comparing with the haematopoietic neoplasmS,there were permeative destruction 15 cases and moth-eaten patteren of destruction 39 cases in non-haematopoietic neoplasms.Both haematopoietic neoplasms and non-haematopoietic neoplasms could appearace permeative and moth-eaten patteren of destruction.plasmacytoma often appearance moth-eaten patteren of destruction.non-Hodgkin lymphoma often appearance permeative destruction.Moth-eaten patteren of destruction was more commo saw in non-haematopoietic neoplasms.4. The signal of soft tissue massThere were 30 case had the MRI examination of the 38 cases solitary lesion haematopoietic neoplasms.The soft tissue mass appearaced uniform signal 21 case and inhomogeneous signal 9 case.5.Pathologic fractureOf the 64 cases haematopoietic neoplasms,there were 11 cases show bone destruction with pathologic fracture.Comparing with the haematopoietic neoplasms,there were only one case show bone destruction with pathologic fracture.So the pathologic fracture was common in haematopoietic neoplasms.ConclusionThe incidence of male is higher than female in haematopoietic neoplasms.The male-to-female ratio is nearly the same as non-haematopoietic neoplasms.The age of haematopoietic neoplasms is higher than non-haematopoietic neoplasms.The pathologic fracture was common in haematopoietic neoplasms.Of the sarcoma in pelvis bones,the multiple lesion is much more often saw in haematopoietic neoplasms than non- haematopoietic neoplasms.Region â… +â…¡ were more common involved in haematopoietic neoplasms.Haematopoietic neoplasms could appearace permeative and moth-eaten patteren of destruction.plasmacytoma often appearance moth-eaten patteren of destruction.non-Hodgkin lymphoma often appearance permeative destruction.The soft tissue mass of haematopoietic neoplasms often appearace uniform signal.PART 3 The comparision of imaging and pathologic features in periacetabular malignant bone tumorObjective:A retrospective analysis was made on the imaging and pathologic features of 92 cases in solitary lesion malignant bone tumor in pelvis bones(including periacetabular tumor 44 cases and non-periacetabular tumor 48 cases) from 2005 to 2014. All cases were confirmed by operation or biopsy and pathology. Comparing the imaging appearances of non-periacetabular tumor,and getting the imaging feature of periacetabular tumor. The object is to improving the diagnosis and differential diagnosis of periacetabular tumor,and providing more information to clinical.Materials and Methods:1.Object:From Jan.2005 to Dec.2014 120 malignant bone tumors were selected from the Nanfang PACS of the Southern medical university Nanfang hospital and Landwind PACS of Hongkong university-Shenzhen hospital. All cases were confirmed by operation or biopsy and pathology.Excluding the multiple lesion tumor 28cases,there were still 92 solitary lesion tumors.Of the 92 cases,there were periacetabular tumor 44 cases and non-periacetabular tumor 48 cases.There were 38 cases are solitary lesion disease,including plasmacytoma 18 cases and non-Hodgkin lymphoma 20 cases.Of the plasmacytoma 18 cases,16 cases had X-ray examination,8 cases had CT scan,and 14 cases had MRI examination. Of the non-Hodgkin lymphoma 20 cases,19 cases had X-ray examination,8 cases had CT scan,and 13 cases had MRI examination.2. Research methodX-ray examination:SIEMENS Aristos MX digital X-ray machine underwent frontal and lateral X-ray films when exam hip joint and pelvis. CT examination:GE Lightspeed 16 multi-detector helical CT and SIEMENS SOMATOM Definition AS 64 multi-detector helical CT,non-ionic contract agent was iohexol(300mgl/ml). MRI examination:GE 3.0T MRI scanner and SIEMENS 1.5T MRI machine. Choose the body coils according to lesions. Contract materials were Gd-DTPA.The images were diagnosis by three experienced doctor form radiology department. The data were blinded. If there were any opinions differ in sign observed,the verdict given by the superior doctor. The clinical manifestation include age,sex and location. The observation of imaging include bony destruction, pathologic fracture,tumor bone,calcification,osteosclerosis,and the signa of the soft tissue mass in MRI examination.RESULT1. LocationOf the 44 cases periacetabular tumor,there were solitary region 3 cases and multiple regions 41 cases.The periacetabular tumor often in multiple regions,and more common in region â… +â…¡.On the other hand,non-periacetabular tumor were more common involved the solitary region.All the pathology types can be in region â… ,but non-Hodgkin lymphoma,chondrosacoma,osteosarcoma and Ewing sarcoma more common in region â… +â…¡.2. Bone destructionOf the 44 cases periacetabular tumor,there were all Osteolytic bone destruction(including permeative destruction 20 cases and moth-eaten patteren of destruction 24 cases).Non-Hodgkin lymphoma was more often appearancing permeative destruction. Chondrosarcoma and the rare pathology type tumor were more often appearancing moth-eaten patteren of destruction.Comparing with the periacetabular tumor,there were permeative destruction nine cases and moth-eaten patteren of destruction 39 cases in non-periacetabular tumor.plasmacytoma,Osteosarcoma and the rare pathology type tumor were often appearancing moth-eaten patteren of destruction.3.The signal of soft tissue massThere were 31 case had the MRI examination of the 44 cases periacetabular tumors.The soft tissue mass appearaced uniform signal 13 cases and inhomogeneous signal 18 cases.There were 25 cases had the MRI examination of the 48 cases non-periacetabular tumors.The soft tissue mass appearaced uniform signal seven cases and inhomogeneous signal 18 cases.ConclusionOf the malignant bone tumor of pelvic bones,the multiple regions are more common saw in periacetabular tumors than non-periacetabular tumors.periacetabular tumors often involove the region â… and â…¡.The periacetabular tumors could appearace permeative and moth-eaten patteren of destruction.There were no significant differences in the signal of soft tissue mass between periacetabular and non-periacetabular tumors.There are some imaging features of common pathological types in periacetabular.But the rare pathological types lack the imaging features. |
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