Biopsy results came back last week. Histopathologic analysis excluded
infection osteomyelitis and neoplastic lesions and showed nonspecific
inflammatory changes with granulocyte infiltration with occasional
granulomas and increased osteoblastic activity. Microbiology and autoimmune
panel negative. CRMO is probably the diagnosis.
Below are the responses
Cheers
Lucas
*1 – CRMO / SAPHO ou JIA?*
*2- Hi Lucas!*
*Was sarcoidosis ruled out?*
*2- CRP and ESR changes suggest to me granulomatous processes-TB atypical
TB sarcoid etc*
*3- ? Physeal right ASIS lesion core PSIS iliac lesions. Easy to get CXR
and help stage. *
*Partially Rx treat pyogenic infection. *
*Systemic blue cell neoplasm Pnet, EG are considered need histo diagnosis
FNA/core*
*Hope this helps. BAH*
*4 – ? Lymphoma*
*5- sclerosis can be old healed infection or prior crmo- no edema on mri*
*lytic – benign- ignore*
*OT-RADS 3*
*5 – My only thought would be a CRMO/CNO but maybe not in the classical
locations. *
*6 – MULTICENTRIC OSTEOSARCOMA[OSTEOSARCOMATOSIS]*
*7- CRMO *
* Eosinophilic granulomatosis*
* LCH*
*8- This could be chronic recurrent multifocal osteomyelitis (CRMO).*
*9- Hi Lucas,*
*Good case! I have thought of hematological malignancies such as lymphoma
and leukemia. And autoinflammatory conditions like chronic non bacterial
osteomyelitis and histiocytosis. Imaging really doesn’t fit these
differentials, particularly the last two. Its heterogeneous imaging
presentation with both sclerotic and lytic lesions makes me think of
multifocal lymphoma of bone (I couldn’t find imaging characteristics in the
pediatric population…), and it’s not aggressive as the adult’s
counterpart… Another thought would be fibrous dysplasia, but it wouldn’t
explain the fever and inflammatory markers. What I’m trying to say is that
I don’t know! hahaha. I’m favouring multifocal lymphoma of bone even though
the chances are low… Looking forward to knowing your *
*thoughts and the biopsy results!*
*10 – Hi Lucas,*
*Had a case similar to this. Turned out to be eosinophilic granuloma.*
*Regards*
———- Forwarded message ———
De: Lucas Da Gama Lobo <gamalobolucas@gmail.com>
Date: qua., 9 de fev. de 2022 às 10:05
Subject: MULTIPLE LYTIC AND SCLEROTIC BONE LESIONS; ADOLESCENT FEMALE
To: OCAD-MSK <ocad-msk@googlegroups.com>
Dear Ocaders
Please advise on the case attached.
Thanks
Lucas
16-year-old-female.pptx 