Weekly Chest CasesImaging Conference Cases

Case No : 8

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  • Age/Sex 21 / M
  • Case Title 21-year-old man with fever and chil for 45 days. History of pedestrian traffic accident Discusser: Resident from Kyunghee University Hospital
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Diagnosis With Brief Discussion

Courtesy
Yonsei University Sinchon Severance Hospital
Discussion
Rib Lesions
- Rib tumor
Primary
Malignancy: chondrosarcoma, plasmacytoma, lymphoma, osteosarcoma, MFH
Benign: osteochondroma, enchondroma, osteoblastoma, osteoid osteoma, chondroblastoma, hemangioma
Metastasis, direct invasion
- Infectious disease
Osteomyelitis & abscess; fungal, tuberculosis, actinomycosis, other bacteria
- Others
Fibrous dysplasia, Langerhans cell histiocytosis, Paget disease, renal osteodystrophy, hemoglobinopathies-
- Rib lesion 25/1034 (Chest CT readings for 3 months in Severance hospital)
Lung cancer ?9 (pancoast tumor 3)
Metastasis ?9 (breast ca 4, HCC 2, RCC 1, ovary cancer 1, unknown 1)
Myeloma ?4
Lymphoma ?2
Benign ?1 (osteochondroma)

Skeletal Involvement of Hodgkin's Disease
- 10-25% of cases of HD
- infrequent at the time of clinical presentation
- more common in adult>child
- Pain is the most common symptom
- hematogenous or direct spread from LN
- Prognosis : depends on histologic type
- common site: spine, pelvis, rib, femur, sternum, scapula
- multiple lesion (2/3) > solitary form
- Osteolytic (75%), Osteosclerotic (15%), mixed (10%)
* diffuse sclerosis of vertebral body ( ivory vertebra ) : similar skeletal metastasis, Paget뭩 disease
Keywords
Mediastinum, Rib, Lymphproliferative disorder, Lymphoma,
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

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