Ewing's sarcoma x ray: Difference between revisions

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Revision as of 18:14, 2 October 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-In-Chief: Michael Maddaleni, B.S.

X Ray

X Ray of Bones

X ray add valuable information in the initial evaluation of Ewing sarcoma:

Most commonly, radiographs show a long, permeative lytic lesion in the metaphysis and diaphysis of the bone with a prominent soft tissue mass extending from the bone.
Periosteal reaction usually is present, and it often has an onionskin or sunburst pattern, which indicates an aggressive process.
In some patients, Codman triangle may be present at the margins of the lesion. These result from the elevation of the periosteum and central destruction of the periosteal reaction caused by the tumor.
The wide zone of transition (e.g. permeative) is the most useful plain film characteristic in differentiation of benign versus aggressive or malignant lytic lesions.

The appearance of these tumours is very variable, but usually have clearly aggressive appearance. Common findings include 2:

permeative: 76% laminated (onion skin) periosteal reaction: 57% sclerosis: 40%

They occasionally demonstrate other appearances, including Codman triangles, spiculated (sunburst) or thick periosteal reaction and even bone expansion or cystic components.

Soft tissue calcification is uncommon, seen in less than 10% of cases 2.

X-Ray of a child with Ewing's sarcoma of the tibia

Radiograph demonstrates classic sunburst pattern of periosteal reaction.

Chest X Ray

Chest X-ray and chest CT scan: This plain x-ray and CT scan of your chest may be done to see if the cancer has spread to your lungs.

References

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 ===X Ray of Bones===
+X ray add valuable information in the initial evaluation of Ewing sarcoma:
+* Most commonly, radiographs show a long, permeative lytic lesion in the metaphysis and [[diaphysis]] of the bone with a prominent soft tissue mass extending from the bone.
+* Periosteal reaction usually is present, and it often has an '''onionskin or sunburst pattern''', which indicates an aggressive process.
+* In some patients, [[Codman triangle]] may be present at the margins of the lesion. These result from the elevation of the [[periosteum]] and central destruction of the [[periosteal reaction]] caused by the tumor.
+*  The wide zone of transition (e.g. permeative) is the most useful plain film characteristic in differentiation of benign versus aggressive or malignant lytic lesions.
+The appearance of these tumours is very variable, but usually have clearly aggressive appearance. Common findings include 2:
+permeative: 76%
+laminated (onion skin) periosteal reaction: 57%
+sclerosis: 40%
+They occasionally demonstrate other appearances, including Codman triangles, spiculated (sunburst) or thick periosteal reaction and even bone expansion or cystic components.
+Soft tissue calcification is uncommon, seen in less than 10% of cases 2.
-* Both [[long bones|long]] and [[flat bones]] are affected.
-* In the long bones, the [[tumor]] is almost always metaphyseal or diaphyseal.
-* Most commonly, radiographs show a long, permeative lytic lesion in the metadiaphysis and [[diaphysis]] of the bone with a prominent soft tissue mass extending from the bone.
-* Periosteal reaction usually is present, and it often has an '''onionskin or sunburst pattern''', which indicates an aggressive process.
-* In some patients, [[Codman triangle]]s may be present at the margins of the lesion. These result from the elevation of the [[periosteum]] and central destruction of the [[periosteal reaction]] caused by the tumor.
-* Plain films add valuable information in the initial evaluation or screening. The wide zone of transition (e.g. permeative) is the most useful plain film characteristic in differentiation of benign versus aggressive or malignant lytic lesions.
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