The Pathology of the Uremic Bone Lesion

1985 ◽  
pp. 127-138
Author(s):  
Steven L. Teitelbaum
Keyword(s):  
Bone Lesion

scholarly journals Diagnostic Value of Whole-Body MRI Short Protocols in Bone Lesion Detection in Multiple Myeloma Patients

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1053
Author(s):  
Davide Ippolito ◽  
Teresa Giandola ◽  
Cesare Maino ◽  
Davide Gandola ◽  
Maria Ragusi ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Bone Marrow Involvement ◽  
Bone Lesion ◽  
Diagnostic Value ◽  
Lesion Detection ◽  
Lower Limbs ◽  
Whole Body ◽  
Bone Lesions ◽  
Whole Body Mri ◽  
Mri Protocol

The aim of the study is to evaluate the effectiveness of short whole-body magnetic resonance imaging (WBMRI) protocols for the overall assessment of bone marrow involvement in patients with multiple myeloma (MM), in comparison with standard whole-body MRI protocol. Patients with biopsy-proven MM, who underwent a WBMRI with full-body coverage (from vertex to feet) were retrospectively enrolled. WBMRI images were independently evaluated by two expert radiologists, in terms of infiltration patterns (normal, focal, diffuse, and combined), according to location (the whole skeleton was divided into six anatomic districts: skull, spine, sternum and ribs, upper limbs, pelvis and proximal two-thirds of the femur, remaining parts of lower limbs) and lytic lesions number (<5, 5–20, and >20). The majority of patients showed focal and combined infiltration patterns with bone lesions predominantly distributed in the spine and pelvis. As skull and lower limbs are less frequently involved by focal bone lesions, excluding them from the standard MRI protocol allows to obtain a shorter protocol, maintaining a good diagnostic value.

scholarly journals Influence of dosimetry method on bone lesion absorbed dose estimates in PSMA therapy: application to mCRPC patients receiving Lu-177-PSMA-I&T

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Julia Brosch-Lenz ◽  
Carlos Uribe ◽  
Astrid Gosewisch ◽  
Lena Kaiser ◽  
Andrei Todica ◽  
...  
Keyword(s):  
Organs At Risk ◽  
Bone Lesion ◽  
Absorbed Dose ◽  
Hounsfield Unit ◽  
Outcome Data ◽  
Computational Effort ◽  
Bone Lesions ◽  
Castration Resistant Prostate Cancer ◽  
Percentage Difference ◽  
Density Weighting

Abstract Background Patients with metastatic, castration-resistant prostate cancer (mCRPC) present with an increased tumor burden in the skeleton. For these patients, Lutetium-177 (Lu-177) radioligand therapy targeting the prostate-specific membrane antigen (PSMA) has gained increasing interest with promising outcome data. Patient-individualized dosimetry enables improvement of therapy success with the aim of minimizing absorbed dose to organs at risk while maximizing absorbed dose to tumors. Different dosimetric approaches with varying complexity and accuracy exist for this purpose. The Medical Internal Radiation Dose (MIRD) formalism applied to tumors assumes a homogeneous activity distribution in a sphere with unit density for derivation of tumor S values (TSV). Voxel S value (VSV) approaches can account for heterogeneous activities but are simulated for a specific tissue. Full patient-individual Monte Carlo (MC) absorbed dose simulation addresses both, heterogeneous activity and density distributions. Subsequent CT-based density weighting has the potential to overcome the assumption of homogeneous density in the MIRD formalism with TSV and VSV methods, which could be a major limitation for the application in bone metastases with heterogeneous density. The aim of this investigation is a comparison of these methods for bone lesion dosimetry in mCRPC patients receiving Lu-177-PSMA therapy. Results In total, 289 bone lesions in 15 mCRPC patients were analyzed. Percentage difference (PD) of average absorbed dose per lesion compared to MC, averaged over all lesions, was + 14 ± 10% (min: − 21%; max: + 56%) for TSVs. With lesion-individual density weighting using Hounsfield Unit (HU)-to-density conversion on the patient’s CT image, PD was reduced to − 8 ± 1% (min: − 10%; max: − 3%). PD on a voxel level for three-dimensional (3D) voxel-wise dosimetry methods, averaged per lesion, revealed large PDs of + 18 ± 11% (min: − 27%; max: + 58%) for a soft tissue VSV approach compared to MC; after voxel-wise density correction, this was reduced to − 5 ± 1% (min: − 12%; max: − 2%). Conclusion Patient-individual MC absorbed dose simulation is capable to account for heterogeneous densities in bone lesions. Since the computational effort prevents its routine clinical application, TSV or VSV dosimetry approaches are used. This study showed the necessity of lesion-individual density weighting for TSV or VSV in Lu-177-PSMA therapy bone lesion dosimetry.

scholarly journals Lesion with blue bone-a case report

2018 ◽  
Vol 8 (1) ◽  
pp. 1323-1325
Author(s):  
Laila Mohamed Ilias ◽  
Babitha Alingal Mohammed ◽  
Roshini PS ◽  
Anupama Ponniah ◽  
Poornima Vijayan
Keyword(s):  
Histopathological Examination ◽  
Fibrous Tissue ◽  
Bone Lesion ◽  
Metacarpal Bone ◽  
Cortical Surface ◽  
Bizarre Parosteal Osteochondromatous Proliferation ◽  
X Ray ◽  
Spindle Cells ◽  
Small Bones ◽  
Hands And Feet

Bizzare parosteal osteochondromatous proliferation, or Nora‘s lesion is a unique bone lesion that most often arises in the small bones of hands and feet.  It is characterised by proliferation of chondroid, bony and fibrous tissue, and is occasionally misdiagnosed as a malignant process.  Our case was a 31 yr old lady, who presented with a painless swelling near the 5th metacarpal bone of right hand.  X-ray showed well marginated mineralised mass arising from the cortical surface of the metacarpal bone.  Histopathological examination revealed bizarre parosteal osteochondromatous proliferation composed of varying amounts of cartilage, bone and spindle cells. Cartilage was hypercellular and chondrocytes were enlarged. Ossification was irregular and had a peculiar blue tinctorial quality. 

Isolated Langerhans Cell Histiocytosis Bone Lesion in Pediatric Patients

2015 ◽  
Vol 153 (5) ◽  
pp. 751-757 ◽  
Author(s):  
Aren Bezdjian ◽  
Abdullah A. Alarfaj ◽  
Namrata Varma ◽  
Sam J. Daniel
Keyword(s):  
Langerhans Cell Histiocytosis ◽  
Pediatric Patients ◽  
Bone Lesion ◽  
Langerhans Cell

Radiology Series: Could this be a malignant bone lesion?

2002 ◽  
Vol 1 (2-3) ◽  
pp. 106-108
Author(s):  
Phua Hwee TANG ◽  
Wilfred CG PEH
Keyword(s):  
Bone Lesion

scholarly journals P259 CORRELATION OF BONE LESION CHANGES WITH CARTILAGE VOLUME LOSS IN KNEE OSTEOARTHRITIS PATIENTS AS ASSESSED BY QUANTITATIVE MRI OVER A TWO-YEAR PERIOD

2006 ◽  
Vol 14 ◽  
pp. S140
Author(s):  
J.-P. Raynauld ◽  
J. Martel-Pelletier ◽  
M.-J. Berthiaume ◽  
F. Abram ◽  
D. Choquette ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Bone Lesion ◽  
Cartilage Volume ◽  
Quantitative Mri ◽  
Volume Loss ◽  
Cartilage Volume Loss

Percutaneous bone lesion ablation

2014 ◽  
Vol 119 (7) ◽  
pp. 462-469 ◽  
Author(s):  
Dimitrios K. Filippiadis ◽  
Sean Tutton ◽  
Alexis Kelekis
Keyword(s):  
Bone Lesion

scholarly journals Bone biopsy in nephrology practice

2018 ◽  
Vol 40 (4) ◽  
pp. 366-374 ◽  
Author(s):  
Fellype de Carvalho Barreto ◽  
Cleber Rafael Vieira da Costa ◽  
Luciene Machado dos Reis ◽  
Melani Ribeiro Custódio
Keyword(s):  
Bone Biopsy ◽  
Bone Lesion ◽  
Bone Diseases ◽  
Serum Biomarkers ◽  
Medical Residency ◽  
Dynamic Information ◽  
Gold Standard Method ◽  
Metabolic Bone Diseases ◽  
Metabolic Bone ◽  
The World

Abstract Renal osteodystrophy (ROD), a group of metabolic bone diseases secondary to chronic kidney disease (CKD), still represents a great challenge to nephrologists. Its management is tailored by the type of bone lesion - of high or low turnover - that cannot be accurately predicted by serum biomarkers of bone remodeling available in daily clinical practice, mainly parathyroid hormone (PTH) and alkaline phosphatase (AP). In view of this limitation, bone biopsy followed by bone quantitative histomorphometry, the gold-standard method for the diagnosis of ROD, is still considered of paramount importance. Bone biopsy has also been recommended for evaluation of osteoporosis in the CKD setting to help physicians choose the best anti-osteoporotic drug. Importantly, bone biopsy is the sole diagnostic method capable of providing dynamic information on bone metabolism. Trabecular and cortical bones may be analyzed separately by evaluating their structural and dynamic parameters, thickness and porosity, respectively. Deposition of metals, such as aluminum and iron, on bone may also be detected. Despite of these unique characteristics, the interest on bone biopsy has declined over the last years and there are currently few centers around the world specialized on bone histomorphometry. In this review, we will discuss the bone biopsy technique, its indications, and the main information it can provide. The interest on bone biopsy should be renewed and nephrologists should be capacitated to perform it as part of their training during medical residency.

scholarly journals A woman with visual loss, amenorrhoea and polyuria: the first reported case of nodular lymphocyte-predominant Hodgkin lymphoma presenting with hypopituitarism

2021 ◽  
Vol 2021 ◽  
Author(s):  
Matthew Seymour ◽  
Thomas Robertson ◽  
Jason Papacostas ◽  
Kirk Morris ◽  
Jennifer Gillespie ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Visual Loss ◽  
Post Partum ◽  
Bone Lesion ◽  
Optic Chiasm ◽  
High Dose ◽  
List Type ◽  
Sellar Mass ◽  
Blurred Vision ◽  
Surgical Biopsy

Summary A 34-year-old woman presented 18 months post-partum with blurred vision, polyuria, amenorrhoea, headache and general malaise. Comprehensive clinical examination showed left superior temporal visual loss only. Initial investigations revealed panhypopituitarism and MRI demonstrated a sellar mass involving the infundibulum and hypothalamus. Lymphocytic hypophysitis was suspected and high dose glucocorticoids were commenced along with desmopressin and thyroxine. However, her vision rapidly deteriorated. At surgical biopsy, an irresectable grey amorphous mass involving the optic chiasm was identified. Histopathology was initially reported as granulomatous hypophysitis. Despite the ongoing treatment with glucocorticoids, her vision worsened to light detection only. Histopathological review revised the diagnosis to partially treated lymphoma. A PET scan demonstrated avid uptake in the pituitary gland in addition to splenic involvement, lymphadenopathy above and below the diaphragm, and a bone lesion. Excisional node biopsy of an impalpable infraclavicular lymph node confirmed nodular lymphocyte-predominant Hodgkin lymphoma. Hyper-CVAD chemotherapy was commenced, along with rituximab; fluid-balance management during chemotherapy (with its requisite large fluid volumes) was extremely complex given her diabetes insipidus. The patient is now in clinical remission. Panhypopituitarism persists; however, her vision has recovered sufficiently for reading large print and driving. To the best of our knowledge, this is the first reported case of Hodgkin lymphoma presenting initially as hypopituitarism. Learning points Lymphoma involving the pituitary is exceedingly rare and, to the best of our knowledge, this is the first reported case of nodular lymphocyte-predominant Hodgkin lymphoma presenting as hypopituitarism. There are myriad causes of a sellar mass and this case highlights the importance of reconsidering the diagnosis when patients fail to respond as expected to appropriate therapeutic intervention. This case highlights the difficulties associated with managing panhypopituitary patients receiving chemotherapy, particularly when this involves large volumes of i.v. hydration fluid.

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