Biomedical subjects
Publications and source records attributed to M J Klein.
A case of prolonged history of synovial chondromatosis of the knee joint that transformed into low-grade chondrosarcoma was reported. The pathological differentiation of this rare entity from synovial chondromatosis has been discussed, as have the radiographic appearance and differential diagnosis.
A case of osteochondroma of the pelvis secondary to radiation therapy after radical nephrectomy for a Wilm's tumor is reported. The occurrence of such a complication has been discussed. Proof was obtained by open biopsy. The indications for surgical resection of such a tumor were considered. The differential diagnosis, though limited, was discussed.
A case of osteochondroma of the pelvis secondary to radiation therapy after radical nephrectomy for a Wilm's tumor is reported. The occurrence of such a complication is discussed. Proof was obtained by open biopsy. The indications for surgical resection of such a tumor were considered. The differential diagnosis, although limited in scope, was discussed.
A large variety of tumor and tumor-like conditions have been shown to originate from the surface of bone (Table 1). Most surface lesions are associated with periosteal reaction. The periosteum is a multipotential membrane. Its cellular composition may give rise to a variety of both neoplasms and tumor-like conditions. To avoid misinterpretation, the orthopedist, radiologist, and pathologist should be familiar with the entire spectrum of surface lesions. A better understanding of the natural history and biological behavior at different lesional maturity stages and correlation of the history with the radiographic and pathological findings is essential to establish the correct diagnosis. A history of injury or blunt trauma is very important. A stress fracture may produce a periosteal reaction acd callus that can be difficult to distinguish from osteosarcoma. In this review article, the authors wish to describe and define each term by its anatomy and radiographic features while discussing the entire spectrum of surface lesions. All the illustrative cases in this review article have been proven histologically.
A rare case of primary leiomyosarcoma of the proximal end of the shaft of the right femur in a 52-year-old man has been reported. Proof was obtained by an open biopsy. The origin, pathological features, and clinical presentation have been discussed. The radiographic appearance, the differential diagnosis, and the poor prognosis of this tumor have also been indicated.
We have presented a young adult with alveolar soft part sarcoma. The lesion occurred in the ankle region and caused extensive bony erosion that mimicked metastasis. At the time of presentation, gingival and subcutaneous metastases were present. Within a short period, however, the patient developed disseminated lung and skeletal metastases as well.
The development of the intermediate lobe of the rabbit pituitary was investigated by light and electron microscopy and by using immunocytological techniques. The first immunoreactive melanotrophic cells were detected at the fetal day 17 in the dorsal zone of Rathke's pouch epithelium facing the neural lobe; this coincided ultrastructurally with the appearance in this area of a few cells exhibiting secretory vesicles and granular condensations in the Golgi saccules. The differentiation of the gland probably required an infundibular inductive effect. Secretory cells increased in number following a dorsoventral gradient during the next fetal and neonatal stages until postnatal day 20, the stage at which the intermediate lobe exhibited its definitive organization. The gland innervation occurred during the first days after birth. The advent of these oxytocin- and neurophysin-immunoreactive fibres coincided with an obvious stimulation of the synthetic activity of the melanotrophic cells. The possible neurotrophic effect of these cells on their innervating system remains to be established.
And unusual case of giant cell tumor in a 3-year-old girl has been presented. The topic of giant cell tumors has been discussed at length. The pathology and the differential diagnosis have been considered. The incidence of giant cell tumors in children and adolescents has also been reviewed and proved to be extremely rare.
The imaging features of four cases of periosteal ganglia were studied. Three lesions were located over the proximal shaft of the tibia, in proximity to the pes anserinus. The fourth lesion involved the distal shaft of the ulna. Three lesions had different degrees of external cortical erosion, scalloping, and thick spicules of periosteal bone on plain radiographs. The bone adjacent to the fourth lesion was not involved. Computed tomography (CT) showed these lesions to be sharply defined soft-tissue masses abutting the periosteum. All of the lesions had the same attenuation as fluid. Magnetic resonance (MR) imaging revealed the ganglia to be sharply defined masses that were isointense compared with neighboring muscles on T1-weighted images. There was markedly increased signal intensity compared with that of fat on T2-weighted images. The signal intensity on both types of images was homogeneous. The MR imaging features were consistent with the fluid nature of the lesions. Under the appropriate clinical circumstances, the MR imaging and CT features of periosteal ganglia are diagnostic.
The expression of the alpha-subunit of the glycoprotein hormones was studied in the developing rat pituitary by in situ hybridization and immunocytochemical techniques. The alpha-subunit mRNA labelling was detected in Rathke's pouch at 12 days' gestation (E12); at E13, it was exclusively concentrated in the pars tuberalis primordium (the lateral lobes) where its intensity rapidly increased at following stages. The alpha-subunit was first immunocytochemically detectable in the pars tuberalis at E14. Labelling of the whole pars tuberalis primordium with both techniques indicated that the specific glandular cells were involved. Immunocytochemical detection of bromodeoxyuridine, injected into the pregnant rat 4 h prior to fixation, revealed a total arrest of cell divisions in the pars tuberalis between E13 and E17, which was not the case in the pars distalis or the pars intermedia at any stage. In the pars distalis, the onset of alpha-subunit expression was detected much later than in the pars tuberalis, at E16-17 by in situ hybridization and at E17-18 by immunocytology. The functional significance of the early secretory differentiation of the pars-tuberalis-specific cells remains to be established.
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Intramuscular myxoma is a distinct benign tumor confined to muscles. This tumor usually favors the thigh and shoulder. We are reporting a case of intramuscular myxoma of the forearm in an elderly female, a very rare site for this tumor. The magnetic resonance features of intramuscular myxoma are described. The differential diagnosis that included acute hematoma, acute abscess, intramuscular synovial cyst, schwannoma and malignant soft tissue tumors with myxomatous degeneration is discussed. The association between intramuscular myxomas and fibrous dysplasia has been emphasized.
Multiple hamartoma syndrome, also known as Cowden's disease, is a rare genodermatosis with characteristic mucocutaneous lesions associated with multiple internal abnormalities. We describe a patient having classic dermatologic manifestations of Cowden's disease and multiple neoplasia including follicular adenocarcinoma of the thyroid gland with lung metastasis, intraductal breast carcinoma within a fibroadenoma, and an osteosarcoma. To our knowledge, this is the first reported case of an osteosarcoma in Cowden's disease.
We described a case of high-grade surface sarcoma of the radius in a 14-year-old boy. The lesion appeared radiologically benign and was confined to the surface. The tumor was resected. At the time of biopsy both lungs showed diffuse metastases. Following surgery the patient underwent chemotherapy and the lung metastases improved. The pertinent literature was briefly discussed.
Hydroxyapatite (HA), a natural constituent of bone, was studied as a particulate carrier for beta-emitting radionuclides in radiation synovectomy. Particles were radiolabeled with 153Sm or 186Re and their in vivo safety was investigated following intra-articular injection into knees of normal rabbits and rabbits with antigen-induced arthritis (AIA). Radiolabeling efficiency was greater than 95%; in vitro studies showed minimal (< or = 1%) loss of activity from particles over a 6-day period with 153Sm-labeled HA and about 5% loss of activity over a 5-day period with 186Re-labeled HA. The total cumulative extra-articular leakage of 153Sm over 6 days was 0.28% in normal rabbits and 0.09% in AIA rabbits. Leakage of 186Re from the joint was 3.05% over a 4-day period with 80% of extra-articular activity found in the urine. Histopathological evaluation of treated knees showed that HA particles are distributed throughout the synovium, embedded in the synovial fat pad. The ease and efficiency with which this HA carrier is labeled, coupled with observed extremely low leakage rates from the joint, make radiolabeled HA particles an attractive candidate as a radiation synovectomy agent for evaluation in rheumatoid arthritis patients.
A case of eosinophilic granuloma in an unusual location (ischium) is presented. Eosinophilic granuloma, a benign lesion of bone, has many radiographic appearances that vary with location. The flat bone of the skull and pelvis are common sites of involvement. Although the iliac wings and pubic rami are not uncommon sites for such a lesion, the ischium is a rare site. This occurrence prompted us to report this case.
The MRI features of bilateral xanthoma of the achilles tendon in type II hyperlipoproteinemia are reported. MRI has proved to be the best imaging modality available in assessing enlargement of the Achilles tendon. It demonstrates the heterogeneous signal on both T1- and T2-weighted images where the xanthomatous deposits are relatively higher in signal intensity than the tendon itself. MRI also has a potential value in the clinical assessment and therapeutic response of the xanthoma after operative intervention.
We present a patient with parosteal osteosarcoma. The lesion arose at the surface of the femur without involvement of the marrow cavity. Some 24 months following resection of the involved bone, she developed distant metastases with no evidence of local recurrence. Neither the primary nor the metastatic lesions showed high-grade malignancy.