Chronic recurrent multifocal osteomyelitis: A great clinical and radiologic mimic in need of recognition by the pathologist
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摘要The spectrum of histopathologic changes in four cases of chronic recurrent multifocal osteomyelitis encountered in our orthopedic outpatient clinic in the past 3 years was studied in conjunction with clinical and radiologic findings. All presented with pain with or without swelling in the affected region. Radiographically, the appearance of the lesions varied from a mixed picture of bone lysis and sclerosis with expansion to sclerosis alone to bone collapse. Bone scintigraphy demonstrated asymptomatic and separate foci of activity in all cases. Prior to biopsy, the clinical and radiologic differential diagnoses included Ewing's sarcoma, metastatic neuroblastoma, hematolymphoid malignancy, Langerhans cell histiocytosis and chronic infection, notably tuberculosis. The spectrum of histopathologic changes ranged from acute (acute inflammatory infiltration, active bone resorption and necrosis, reactive bone formation) to subacute (predominantly lymphocytic and plasma cell infiltration) to chronic inflammation (fibroblastic organization and bony sclerosis). Histologic changes correlated poorly with clinical features, but relatively well with radiologic findings. Lesional excision was performed in one case, cortical saucerization in another, while the final two cases received supportive treatment. All remained well 18-21 months post-therapy. Chronic recurrent multifocal osteomyelitis is a great clinical and radiologic mimic, which merits recognition by the pathologist. Awareness of the spectrum of histologic features encountered enables a correct diagnosis to be made in the appropriate clinical setting. The patient can thus be reassured of a favorable prognosis.
著者Chow LTC, Griffith JF, Kumta SM, Leung PC
期刊名稱APMIS
出版年份1999
月份4
日期1
卷號107
期次4
出版社MUNKSGAARD INT PUBL LTD
頁次369 - 379
國際標準期刊號0903-4641
電子國際標準期刊號1600-0463
語言英式英語
關鍵詞bone; chronic recurrent multifocal osteomyelitis; histology; osteomyelitis
Web of Science 學科類別Immunology; IMMUNOLOGY; Microbiology; MICROBIOLOGY; Pathology; PATHOLOGY

上次更新時間 2020-29-11 於 01:59