Tumors of the Spine: When Can Biopsy Be Avoided?

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: None declared. 6. Semin Musculoskelet Radiol. 2019 Feb;23(1):36-57. doi: 10.1055/s-0038-1676125. Epub 2019 Jan 30. Ewing's Sarcoma and Primary Osseous Lymphoma: Spectrum of Imaging Appearances. Weber MA(1), Papakonstantinou O(2), Nikodinovska VV(3), Vanhoenacker FM(4). Author information: (1)Institute of Diagnostic and Interventional Radiology, University Medical Center Rostock, Rostock, Germany. (2)Second Department of Radiology, National and Kapodistrian University of Athens "Attikon" Hospital, Athens, Greece. (3)Department of Radiology, University Surgical Clinic "St. Naum Ohridski," University "Ss. Cyril and Methodius," Skopje, Macedonia. (4)Department of Radiology, AZ Sint-Maarten Mechelen, University Hospital Antwerp, Ghent University, Mechelen, Belgium. Ewing's sarcoma (ES) is a rare, highly malignant anaplastic stem cell tumor. Histologically, the tumor consists of uniform densely packed small monomorphic cells with round nuclei. The typical appearance at hematoxylin and eosin (H&E) staining is small blue round cells without any matrix formation. On conventional radiography, ES typically presents as a permeative lesion in the diaphysis of a long bone in a child. A large soft tissue component is another characteristic feature, best depicted by magnetic resonance imaging.Primary osseous lymphomas are most commonly highly malignant B-cell lymphomas. At H&E histologic staining, the tumor stroma consists of diffuse round-cell infiltrates that resembles the appearance of ES. Although there is no typical imaging appearance of an osseous lymphoma, it should be considered in an adult presenting with a Lodwick grade II or III lesion in the metaphysis or diaphysis of a large long bone, the pelvis, or the vertebral column. Histologic confirmation is mandatory. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA. DOI: 10.1055/s-0038-1676125