Incidence Of Bone Involvement Research Articles

Staging 68Ga-PSMA PET/CT in 963 consecutive patients with newly diagnosed prostate cancer: incidence and characterization of skeletal involvement.

The aim of the study was to elaborate the incidence and type of skeletal involvement in a large cohort of patients with newly diagnosed prostate cancer (PCa) referred for Ga-68 PSMA-11 PET/CT staging in a single center. Study cohort included 963 consecutive patients with newly diagnosed PCa referred for Ga-68 PSMA-11 PET/CT study for staging. The incidence of bone involvement, type of bone metastases, and extent of disease were determined and correlated with the ISUP Grade Group (GG) criteria and PSA levels. Bone metastases were found in 188 (19.5%) of 963 patients. Bone metastases were found in 10.7% of patients with PSA < 10ng/dL and in 27.4% of patients with PSA > 10ng/dL and in 6.1% of patients with GG ≤ 2/3 and in 8.9% of patients with GG 4/5. In 7.6% of the patients, skeletal involvement was extensive, while 11.9% of patients had oligometastatic disease. Osteoblastic type metastases were the most common type of bone metastases presented in 133 of the patients with malignant bone involvement (70.7%). More than half of them had only osteoblastic lesions (72 patients (38.3%)), while the other (61 patients (32.5%)) had also intramedullary and/or osteolytic type lesions. Intramedullary metastases were found in 97 patients (51.6%), while 41 (21.8%) of them were only intramedullary lesions. Osteolytic metastases were detected in 36 patients (19.2%), of which 8 were only osteolytic lesions. Although traditionally bone metastases of PCa are considered osteoblastic, osteolytic and intramedullary metastases are common, as identified on PET with labeled PSMA. Skeletal spread may be present also in patients with GG ≤ 2/3 and PSA < 10ng/dL.

Osseous cystic echinococcosis: A case series study at a referral unit in Spain.

BackgroundCystic echinococcosis (CE) is present in all continents, except for the Antarctica. Characteristically, CE lesions are found in the liver and the lungs, but virtually any part of the body may be affected (the spleen, kidneys, heart, central nervous system, bones, among others). It is estimated that the incidence of bone involvement in CE is 0.5% to 4%.MethodologyA retrospective study was performed of patients with osseous CE treated at the National Reference Unit of Tropical Diseases of the Ramon y Cajal Hospital, Madrid, Spain, between 1989 and December 2017. Epidemiological, clinical, diagnostic and therapeutic data of patients with long-term follow-up were collected.Main findingsDuring the study period, of the 104 patients with CE, 27 exhibited bone involvement (26%). The bones most frequently affected were the spine, followed by the ribs, pelvis, femur, tibia and the scapula. The most common symptom was pain followed by medullar syndrome and pathologic fracture. In total, 81.5% of patients underwent surgery for osseous CE at least once. As many as 96% received albendazol either in (mostly long-term) monotherapy or in combination with praziquantel.ConclusionsThe diagnosis and management of osseous CE is challenging. In many cases osseous CE should be considered a chronic disease and should be managed on a case-by-case basis. Lifelong follow-up should be performed for potential recurrence and sequels.

Bone Scintigraphy in Children With Cat Scratch Disease

The objective of this study was to evaluate the degree and incidence of bone involvement in patients with cat scratch disease. Patients admitted between 2004 and 2011 at the pediatric department for cat scratch disease and a positive serology for Bartonella henselae were identified. Only those having undergone a bone scintigraphy (BS) were included in this retrospective study. Sixteen girls and 8 boys with a mean age of 7 years were studied. Bone scintigraphy was positive in 6 (25%), but only 2 had bone pain. Axial involvement was present in all 6 patients, and appendicular lesions in 3 of them. Three patients had a BS control, with improvement or normalization after treatment with antibiotics. Bone involvement occurs infrequently in patients with cat scratch disease and is not always associated with specific signs. Cat scratch disease must be suspected in patients with fever of unknown origin presenting multifocal lesions on BS.

Detection of micrometastatic prostate cancer cells in the bone marrow of patients with prostate cancer.

Thirty-five patients with prostate cancer were examined for micrometastases to the bone marrow using reverse transcription-polymerase chain reaction (RT-PCR) with primers specific for the prostate-specific antigen (PSA) gene. Of nine patients with bone metastases detectable by bone scan imaging, five patients had PSA mRNA expression in the bone marrow detectable by RT-PCR. Of 26 patients with negative bone scan findings, seven patients had PSA mRNA expression detectable in the bone marrow. RT-PCR could detect micrometastatic prostate cancer cells in the bone marrow that were not detectable by bone scan imaging. Of 16 patients with a serum PSA concentration of 25 ng ml(-1) or greater, only nine (56.3%) had bone metastases detected by bone scans. Of the remaining seven patients, five had micrometastases to the bone marrow detected by RT-PCR. Overall, 14 of 16 patients (87.5%) with a serum PSA concentration of 25 ng ml(-1) or greater had metastatic bone diseases including bone marrow micrometastases. Of 19 patients with a serum PSA concentration of less than 25 ng ml(-1), two (10.5%) had only micrometastatic disease detected by RT-PCR. A significant correlation was observed between the incidence of bone involvement and the serum PSA concentration. This study suggests that RT-PCR will potentially develop into a relevant tool to assess bone involvement including bone marrow micrometastases and establish a precise correlation between serum PSA concentration and metastatic bone disease in patients with prostate cancer.

Bone Involvement in Malignant Lymphoma

The purpose of this study is to review the problem of involvement of bone by malignant lymphoma, to attempt to determine what influence, if any, such involvement may have on the course of the disease and well-being of the patient, and to try to solve such other problems related to the disease as the extent and nature of the data available will allow. In the Tumor Clinic of the Massachusetts General Hospital, in the ten-year period from January 1936 through December 1945, a clinical diagnosis of lymphoma of one variety or another was made in 402 patients 2.In 313 of these the diagnosis was proved by histologic examination, either of a specimen secured by biopsy or during a surgical operation, or at autopsy. Discarding 25 cases of mycosis fungoides, there remain 288 histologically proved cases upon which the following review is based. The determination of involvement of bone was by means of roentgenograms and by postmortem examination. In one case only was bone involvement found postmortem which had not been previously recognized roentgenologically. While it is well known that considerable involvement of bone by tumor is necessary before demonstration by roentgenogram is possible, it would seem that in these cases of malignant lymphoma the disease progressed slowly enough so that the majority of the bone lesions were diagnosed antemortem. Exclusive of the leukemias and the disease which is termed paragranuloma by Jackson and Parker (5, 6), the classifications adhered to in this community are that of the latter authors and that of Gall and Mallory (3); the two are quite similar save for nomenclature. For the purpose of this study, and in order that no individual group may be too small, the classification of Jackson and Parker is used. Incidence of Bone Involvement In Table I, Column A shows the grouping of the 288 cases. Hodgkin's granuloma is the most commonly occurring form of malignant lymphoma, almost one-third of the patients falling into that group; Hodgkin's sarcoma and giant-cell follicular lymphoma are the least common, each accounting for less than 10 per cent of the series. Of the entire group of 288 patients, 38 or 13 per cent had manifest involvement of bone at the time of the first observation or sometime later in the course of the disease. As seen in Column B (Table I), the incidence of discrete bone involvement in each group of patients roughly parallels the frequency of the disease in the group as a whole, with the exception of the giant follicular type of lymphoma in which the figure is disproportionately low.

Vertebral Involvement in Hodgkin's Disease

THE incidence of bone involvement in Hodgkin's disease is much higher than we have been led to believe by reports in the literature, and a more frequent complete radiologic investigation of the skeleton in cases suspected of Hodgkin's will, not infrequently, show osseous involvement, even though this may not be clinically suspected. Jenkinson states that in the study of his cases there was evident a similarity between bone metastases of carcinoma and bone changes in Hodgkin's disease. Reisner and Brada state that in their series of Hodgkin's cases, 74 per cent presented bone involvement, and in approximately 50 per cent of these, the lesions were situated in the spinal column. Bone involvement, however, is usually considered a late development in the course of the disease. As in carcinoma, the vertebra, ribs, pelvis, and femora are most frequently the site of changes in Hodgkin's disease. Lock-wood, Johnson, and Narr report a case of a boy, aged 15 years, in whom a roentgenogram revealed definite bone des...

Hodgkin's Disease

THE etiology, symptoms, prognosis, and pathology of Hodgkin's disease have been thoroughly covered by many writers, particularly Yates and Raine, Bunting, and others. I am chiefly concerned with the accompanying osseous changes and the treatment. I am quite sure that the incidence of bone involvement in Hodgkin's disease is much higher than the literature would lead us to believe. As we become more thorough in our examinations, insisting upon complete radiologic investigation of the skeleton, more and more will we find osseous involvement. At the present writing, it is impossible to give statistics on the frequency with which bony changes occur. One cannot rely on the figures quoted in the older literature—the autopsies were not complete, and thorough X-ray examinations were not made. It has occurred to us in the study of our cases that there is a similarity between bone metastases following carcinoma and bone changes in Hodgkin's disease. Review of the bones usually attacked by carcinomas and Hodgkin's d...