Case Of the Week (COW) 12 June 2016
Aneurysmal Bone Cyst
Findings:
Plain x-ray shows expansile lytic lesion involving rt pedicle and spinous process of L4 vertebra
MRI-Evidence of 6.4 x 5.7 x 4.9cm well defined expansile lytic lesion with septation and blood fluid levels noted involving right pedicle, right transverse process and right body of L4 vertebra.
Discussion:
Aneurysmal bone cyst: Benign expansile tumour like bone lesion of uncertain etiology composed of numerous blood filled channels Most commonly seen in children and adolescents < 20 yrs Most common location Long bones – proximal tibia , femur Spine( posterior elements) and sacrum X- Ray and Ct: Sharply defined expansile osteolytic lesion with thin sclerotic margins. Bone scan: Doughnut sign – Increased uptake peripherally with photopenic centre. MRI: Cysts of variable signals with surrounding rim of low T1 and T2 signals. Focal areas of high T1 and T2 signals seen representing areas of blood of variable age. Fluid fluid levels will be seen.
Aneurysmal Bone Cyst
Findings:
Plain x-ray shows expansile lytic lesion involving rt pedicle and spinous process of L4 vertebra
MRI-Evidence of 6.4 x 5.7 x 4.9cm well defined expansile lytic lesion with septation and blood fluid levels noted involving right pedicle, right transverse process and right body of L4 vertebra.
Discussion:
Aneurysmal bone cyst: Benign expansile tumour like bone lesion of uncertain etiology composed of numerous blood filled channels Most commonly seen in children and adolescents < 20 yrs Most common location Long bones – proximal tibia , femur Spine( posterior elements) and sacrum X- Ray and Ct: Sharply defined expansile osteolytic lesion with thin sclerotic margins. Bone scan: Doughnut sign – Increased uptake peripherally with photopenic centre. MRI: Cysts of variable signals with surrounding rim of low T1 and T2 signals. Focal areas of high T1 and T2 signals seen representing areas of blood of variable age. Fluid fluid levels will be seen.