Limits...
Bone tumor mimickers: A pictorial essay.

Mhuircheartaigh JN, Lin YC, Wu JS - Indian J Radiol Imaging (2014)

Bottom Line: These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes.It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup.Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.

ABSTRACT
Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

No MeSH data available.


Related in: MedlinePlus

Island of red marrow in the sacrum. A 49 year old man with recurrent bloating underwent a MR enterography, which demonstrated an incidental lesion in the sacrum. He was recalled for in-phase and out-of-phase T1W MRI imaging. (A) In-phase T1W MRI image demonstrates the lesion (arrow) is slightly hyperintense to skeletal muscle (B) On the out-of-phase T1W MRI image, there is loss of signal due to the presence of intermixed fatty marrow (arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4126137&req=5

Figure 1: Island of red marrow in the sacrum. A 49 year old man with recurrent bloating underwent a MR enterography, which demonstrated an incidental lesion in the sacrum. He was recalled for in-phase and out-of-phase T1W MRI imaging. (A) In-phase T1W MRI image demonstrates the lesion (arrow) is slightly hyperintense to skeletal muscle (B) On the out-of-phase T1W MRI image, there is loss of signal due to the presence of intermixed fatty marrow (arrow)

Mentions: Erythropoietic or red marrow can be a common cause for concern on magnetic resonance imaging (MRI). This can be particularly problematic if the area of red marrow is mass-like in appearance. Red marrow should be hyperintense to fatty marrow on fat-suppressed T2-weighted (T2W) MRI sequences and hypointense on T1-weighted (T1W) MRI sequences.[1] The key feature is that the low signal intensity on T1W MRI sequences should be higher than that of skeletal muscle or the intervertebral discs.[2] In-phase and out-of-phase T1W MRI images can be helpful in equivocal cases as red marrow should have some intermixed fatty marrow and, consequently, should lose signal (become darker) on out-of-phase compared to in-phase MRI.[3] On the other hand, marrow-replacing tumors, such as many metastases, should replace all the fatty marrow and should not lose signal on out-of-phase T1W imaging [Figure 1]. Thus, when approaching marrow abnormalities on MRI, it is important to have T1W images that include skeletal muscle for comparison and in-phase and out-of-phase T1W images to show the presence or absence of fat. Yellow marrow can reconvert to red marrow with physiologic stressors such as anemia.[4] Moreover, red marrow should not extend past the physeal scar into the epiphysis and should not distort normal trabecular pattern.[5]


Bone tumor mimickers: A pictorial essay.

Mhuircheartaigh JN, Lin YC, Wu JS - Indian J Radiol Imaging (2014)

Island of red marrow in the sacrum. A 49 year old man with recurrent bloating underwent a MR enterography, which demonstrated an incidental lesion in the sacrum. He was recalled for in-phase and out-of-phase T1W MRI imaging. (A) In-phase T1W MRI image demonstrates the lesion (arrow) is slightly hyperintense to skeletal muscle (B) On the out-of-phase T1W MRI image, there is loss of signal due to the presence of intermixed fatty marrow (arrow)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4126137&req=5

Figure 1: Island of red marrow in the sacrum. A 49 year old man with recurrent bloating underwent a MR enterography, which demonstrated an incidental lesion in the sacrum. He was recalled for in-phase and out-of-phase T1W MRI imaging. (A) In-phase T1W MRI image demonstrates the lesion (arrow) is slightly hyperintense to skeletal muscle (B) On the out-of-phase T1W MRI image, there is loss of signal due to the presence of intermixed fatty marrow (arrow)
Mentions: Erythropoietic or red marrow can be a common cause for concern on magnetic resonance imaging (MRI). This can be particularly problematic if the area of red marrow is mass-like in appearance. Red marrow should be hyperintense to fatty marrow on fat-suppressed T2-weighted (T2W) MRI sequences and hypointense on T1-weighted (T1W) MRI sequences.[1] The key feature is that the low signal intensity on T1W MRI sequences should be higher than that of skeletal muscle or the intervertebral discs.[2] In-phase and out-of-phase T1W MRI images can be helpful in equivocal cases as red marrow should have some intermixed fatty marrow and, consequently, should lose signal (become darker) on out-of-phase compared to in-phase MRI.[3] On the other hand, marrow-replacing tumors, such as many metastases, should replace all the fatty marrow and should not lose signal on out-of-phase T1W imaging [Figure 1]. Thus, when approaching marrow abnormalities on MRI, it is important to have T1W images that include skeletal muscle for comparison and in-phase and out-of-phase T1W images to show the presence or absence of fat. Yellow marrow can reconvert to red marrow with physiologic stressors such as anemia.[4] Moreover, red marrow should not extend past the physeal scar into the epiphysis and should not distort normal trabecular pattern.[5]

Bottom Line: These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes.It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup.Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.

ABSTRACT
Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.

No MeSH data available.


Related in: MedlinePlus