Central calcification

Introduction Central chondrosarcoma can be characterized by blurred border osteolysis, with or without cortical bone disruption. Because cartilage tends to be calcified and ossified, X-ray areas can appear in the tumor, and calcification often occurs around the cartilage lobules. structure. It is characterized by irregular hazy particles, nodules or X-ray opaque rings.

Cause

Central chondrosarcoma is a chondrosarcoma that originates in the bone and ranks 4th in primary malignant bone tumors, after plasmacytoma, osteosarcoma, and Ewing's sarcoma. There are obvious areas of good hair, followed by the femur (especially the proximal end), the pelvis, the proximal humerus, the scapula, and the proximal humerus. In aggressive cases, central chondrosarcoma can have extensive cortical disruption in the early stage, large soft tissue masses, and calcification of tumor mass invading soft tissues is not obvious. The infiltrated, perforated periosteum can reactively produce a thin, slightly opaque band perpendicular to the cortex, but never seen a typical "toothbrush" image in an osteosarcoma and a Codman angle.

an examination

Related inspection

CT examination of X-ray lipiodol

X-ray findings: for osteolytic lesions in the bone, there may be calcium salt deposition, most of the tumors grow slowly, and a few grow rapidly. At the -dry end, the tumor is eccentric; at the backbone, it is at the center of the diaphysis.

Central chondrosarcoma can be characterized by blurred border osteolysis, with or without cortical bone disruption. Because cartilage tends to be calcified and ossified, X-ray areas can appear in the tumor, and calcification often occurs around the cartilage lobules. structure. It is characterized by irregular hazy particles, nodules or X-ray opaque rings.

Tumors can produce a blister or bready appearance due to the tumor wall. If the calcification is dense, the tumor may be a metal-impermeable metal sample. If the tumor infiltrates into the medullary canal of the cancellous bone without destroying the trabecular bone, the calcium deposit and the reactive bone hyperplasia may be spongy-like. If the tumor infiltrated cancellous bone does not destroy the trabecular bone and there is no calcification, the tumor part of the bone may not be developed. In this case, the diagnosis of central chondrosarcoma is difficult and late without bone scan, CT and MRI.

Well-differentiated central chondrosarcoma is more calcified, while grade III central chondrosarcoma and dedifferentiated central chondrosarcoma have less calcification and more mucus areas.

The cortical bone can be very thin, and the inside is scalloped. In some areas, there may be interruptions. Sometimes, due to the slow expansion of the tumor, the cortical bone proliferates and may appear thickened. This thickened cortical bone is quite typical, indicating that it has been infiltrated by the tumor.

Central chondrosarcoma tends to expand toward less resistant areas, such as the medullary cavity of the backbone. In almost half of the cases, radiographic images showed that the tumor invaded 1/3, 1/2 or more of the entire long bone, but in the early stages of the tumor, there may be no display on the image. This feature is very important or the surgical plan may be inappropriate. The resection margin may not be sufficient. The tumor may recur after the bone resection or amputation. In order to avoid this, the tumor should be confirmed by bone scan, CT and MRI before surgery. The extent of the cavity.

In aggressive cases, central chondrosarcoma can have extensive cortical disruption in the early stage, large soft tissue masses, and calcification of tumor mass invading soft tissues is not obvious. The infiltrated, perforated periosteum can reactively produce a thin, slightly opaque band perpendicular to the cortex, but never seen a typical "toothbrush" image in an osteosarcoma and a Codman angle.

Differential diagnosis

Differential diagnosis of central calcification:

1. Ectopic calcification: a pathological term. Also known as heterotopic ossification. In addition to normal physiological calcification, calcium deposits occur outside of bone tissue. This change usually occurs at the tendon attachment of the bone, ligaments, blood vessel walls, bone fascia, and the like. Calcium ions are precipitated from the skeletal system and often lead to osteoporosis. Therefore, some scholars advocate ectopic calcification as an indirect sign of osteoporosis.

2. Long bone epiphyseal calcification: cartilage ectodermal dysplasia syndrome, also known as Ellis-van Creveld congenital malformation syndrome, congenital cartilage calcification disorder heart disease syndrome, cartilage ectodermal dysplasia syndrome and other health searches, often Chromosomal recessive hereditary diseases are characterized by short-limb dwarfs, often with congenital heart disease and mental retardation. The newborn baby is in a dwarf state. For example, the long bones of the limbs are short and thick, the distal fingers (toes) are particularly small, and multiple fingers (toes) can appear, hair and teeth develop poorly, and the long bones of the whole body are incompletely calcified.

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