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Primary lymphoma of bone: a population-based study of 2558 patients.

BackgroundPrimary lymphoma of bone (PLB) is an extremely rare malignancy arising in the skeletal system. There is no consensus over the best definition of PLB. Most of the published articles are single-institutional retrospective studies with a limited sample size. The rarity of PLB and discrepancies on diagnostic criteria has resulted in a vague understanding of PLB.MethodsWe retrospectively analyzed the clinical characteristics and prognostic factors of 2558 PLB patients who were registered in the Surveillance, Epidemiology, and End Results (SEER) database from 1973 to 2016. Survival rates w

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… A total of 1430 cases (55.9%) had primary axial bone lesions (including vertebral column, rib, sternum, clavicle, pelvic bones, sacrum, coccyx, and associated joints), while 223 cases (8.7%) had craniofacial bone lesions (including mandible, bones of skull and face and associated joints) and 905 cases … associated joints (C40.2) | 597 | 23.34% Pelvic bones, sacrum, coccyx and associated joints (C41.4) | 356 | 13.92% Long bones of upper limb, scapula, and associated joints (C40.0) | 258 | 10.09% Bone, NOS (C41.9) | 181 | 7.08% Bones of skull and face and associated joints (C41.0) | 130 | 5.08% Rib, sternum, clavicle …

Treatment of relapsed or refractory Hodgkin's lymphoma with lenalidomide combined with PD-1 monoclonal antibody: a case report and literature review.

The current standard treatment for relapsed or refractory Hodgkin's lymphoma involves salvage chemotherapy followed by high-dose chemotherapy and sequential autologous stem cell transplantation. However, for patients who cannot tolerate intense chemotherapy or do not meet the conditions for autologous stem cell transplantation, there is a need to explore new treatment options. We report a case of an elderly patient with multiple relapses of classical Hodgkin's lymphoma who experienced repeated disease progression despite undergoing multiple lines of treatment including novel agents such as CD3

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… Osteoblastic lesions were observed in multiple bones, including the humerus, clavicle, sternum, ribs, and acetabulum. These findings are consistent with Stage IV lymphoma. PET/CT scan of a human body displaying different cross-sectional views, including coronal, axial, and sagittal sections. … New osteolytic lesions (e.g., clavicle, spine, pelvis) were observed, indicating disease progression. PET and CT scan images showing cross-sectional views of a human body from different angles. …

Comparative effects of dual-task training versus combined exercise training in water and on land on patients with multiple sclerosis: a study protocol of a randomised factorial trial.

INTRODUCTION: People with multiple sclerosis (PwMS) experience cognitive and motor impairments, including cognitive training and exercise training. This study compares dual task and combined exercise training in water and on land. Water-based training may enhance cognitive and motor function more effectively than land-based training, presenting a promising intervention for PwMS. We explore dual-task training (DTT), including cognitive and motor exercise, with combined exercise in water and on land on the cognition, balance and gait PwMS. METHODS AND ANALYSIS: This is a double-blind 3*2*2 fact

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… Individual spherical 14 mm retroreflective markers will be placed as follows: C7, T10 and clavicle : on the jugular notch, where the clavicles meet the sternum; sternum: on the xiphoid process of the sternum; shoulder: on the acromioclavicular joint; finger: just proximal to the middle knuckle on the …

Osteolytic Bone Lesions - A Rare Presentation of AML M6.

Acute myeloid leukemia (AML) M6 is a rare form of AML accounting for < 5 % of all AML. Extramedullary involvement is very rarely seen in this entity. Skeletal lesion has not been described in AML M6 before. We discuss the case of a 17 year old boy with AML M6, who presented with osteolytic lesion of right humerus. He was treated with induction and consolidation chemotherapy. The present case is the first report in literature of AML M6 presenting with skeletal lesions.

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… Magnetic resonance imaging showed focal cortical lytic lesion in the head of right humerus and greater tuberocity, glenoid and corocoid process and right clavicle with moderate periosteal reaction ( Figure 2 ). …

Risk Factors for Early Postoperative Morbidity and Mortality following Extremity Metastatic Pathologic or Impending Fracture Fixation.

BACKGROUND: As cancer survivorship continues to improve, the perioperative morbidity and mortality following surgical treatment of metastatic bone disease become an increasingly important consideration. The objective of this study is to identify risk factors for early postoperative complications and mortality following extremity prophylactic fixation and pathologic fracture stabilization. METHODS: A single-centre retrospective review of 185 patients (226 total surgeries) who underwent prophylactic fixation or pathologic fracture stabilization for extremity metastatic bone disease between 2005

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… transfused 2 | 1.20 (1.98, 0–14) Impending versus pathologic fracture 2 | Impending fracture | 98 (43.36%) Pathologic fracture | 128 (56.64%) Surgical location(s) for each surgery 2 | Femur | 158 (69.91%) Humerus | 53 (23.45%) Tibia | 5 (2.21%) Femur and humerus | 4 (1.77%) Femur bilateral | 4 (1.77%) Clavicle … Surgical intervention | Frequency (%) For pathologic fracture | Humerus CCP | 29 (12.83%) Femur CCP | 7 (3.10%) Tibia CCP | 1 (0.44%) Femur IMN | 60 (26.55%) Humerus IMN | 6 (2.65%) Tibia IMN | 1 (0.44%) Clavicle IMN | 1 (0.44%) Hip hemiarthroplasty | 13 (5.75%) THA | 2 (0.88%) DFR | 1 (0.44%) RTSA …

Outcomes and prognostic factors after surgery for bone metastases in the extremities and pelvis: A retrospective analysis of 140 patients.

BACKGROUND: Surgical therapy of bone metastases is becoming increasingly important due to prolonged life expectancy and improved oncological treatment options. In a mostly palliative approach, it is necessary to identify those patients who might benefit from surgery. The shorter the remaining lifetime, the more restricted the indication and the less radical the intervention should be. The aim of this study was to evaluate the postoperative outcomes and prognostic factors for survival of patients with surgically treated bone metastases. METHODS: We retrospectively included 140 patients who und

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… Solitary metastasis Femur | 100 (66.2%) | 47/44/9 | 33 (33.0%) | 67 (67.0%) | 0 Humerus | 26 (17.2%) | 7/15/4 | 21 (80.8%) | 5 (19.2%) | 0 Pelvis | 13 (8.6%) | | 7 (53.8%) | 4 (30.8%) | 2 (15.4%) Tibia | 10 (6.6%) | 4/6/0 | 4 (40.0%) | 5 (50.0%) | 1 (10.0%) Radius | 1 (0.7%) | 0/0/1 | 0 | 0 | 1 (100%) Clavicle … Femur | 34 (34.0%) 18 1 | 61 (61.0%) | 3 (3.0%) | 2 (2.0%) | 0 | 0 Humerus | 5 (19.2%) 5 1 | 15 (57.7%) | 4 (15.4%) | 2 (7.7%) | 0 | 0 Pelvis | 8 (61.5%) 2 1 | 0 | 1 (7.7%) | 2 (15.4%) | 1 (7.7%) | 1 (7.7%) Tibia | 2 (20.0%) 2 1 | 5 (50.0%) | 3 (30.0%) | 0 | 0 | 0 Radius | 0 | 0 | 0 | 1 (100%) | 0 | 0 Clavicle …

Potential for reduced toxicity and dose escalation in the treatment of inoperable non-small-cell lung cancer: a comparison of intensity-modulated radiation therapy (IMRT), 3D conformal radiation, and elective nodal irradiation.

PURPOSE: To systematically evaluate four different techniques of radiation therapy (RT) used to treat non-small-cell lung cancer and to dete … included the primary tumor plus the ipsilateral hilum and mediastinum from the inferior head of the clavicle to at least 5.0 cm below the carina. The goal was to deliver 70 Gy to > or =99% of the planning target volume (PTV) in 35 daily fractions (46 Gy to electively treated mediastinum) while meeting multiple normal-tissue dose constraints. Heterogeneity …

Chest and Mediastinum

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… In the apex of the lung, there is even more difficulty due to the superimposition of soft tissues and the clavicles. Thin-section high-resolution CT enables visualisation of the secondary lobule. … Fig. 19.26 Soft tissue shadows in the chest X-ray Above the clavicle also in thin individuals, the skin may form a fold that runs parallel to the clavicle as a delicate line that passes medially to the sterno-cleidomastoid. Skin folds may mimic the pleural line of pneumothorax. …

Expert consensus on resection of chest wall tumors and chest wall reconstruction.

Chest wall tumors are a relatively uncommon disease in clinical practice. Most of the published studies about chest wall tumors are usually single-center retrospective studies, involving few patients. Therefore, evidences regarding clinical conclusions about chest wall tumors are lacking, and some controversial issues have still to be agreed upon. In January 2019, 73 experts in thoracic surgery, plastic surgery, science, and engineering jointly released the Chinese Expert Consensus on Chest Wall Tumor Resection and Chest Wall Reconstruction (2018 edition). After that, numerous experts put forw

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… SP represents less than 5% of all plasma cell neoplasms ( 17 ) and mostly occurs in the spine, pelvis, and pectoral girdle, while rarely occurring in the sternum, ribs, and clavicle ( 17 - 19 ). … When the manubrium and one or both clavicles are involved, these can be removed without subsequent reconstruction, yielding acceptable shoulder girdle movement. …

Autologous bone marrow transplanation for extramedullary plasmacytoma presenting as adrenal incidentaloma.

Extramedullary adrenal plasmacytoma (EMP) involving the adrenal glands is rarely encountered clinically. We report a A 47-year-old male who presented with bilateral adrenal incidentalomas. After confirming EMP, the patient received two consecutive autologous hematopoietic stem cell transplants (HSCT) using high-dose melphalan. Following HSCT, a serial follow-up helical CT revealed a substantial decrease in the size of both adrenal masses. Serial periodic serum protein and urine electrophoresis and immunofixation showed abrogation of a previously noted monoclonal band. At 50 months follow-up th

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… A skeletal survey (ribs, clavicle, scapulae, skull, spine, long bones of upper and lower extremities, pelvis), whole body bone scan and MRI spine showed no findings suggestive of multiple myeloma. …

High serum IL-17A is associated with bone destruction in newly diagnosed multiple myeloma patients.

BACKGROUND: Multiple myeloma (MM) is a malignant proliferative disease of the blood system, characterized by the abnormal growth of clonal plasma cells in the bone marrow. The bone marrow microenvironment (BMM) is highly critical in the pathological process of MM. Many studies have shown that serum interleukin-17A (IL-17A) plays a key role in various infectious diseases, autoimmune diseases, and cancers. However, more clinical studies need to be performed to further prove the influence of serum IL-17A levels on multiple myeloma patients. METHODS: Among a total of 357 participants in our insti

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… Bone destruction in the skull, scapula, vertebrae, sternum/clavicle, ilium/pelvis/sacrum/pubis, and femur/humeral area detected by MR/CT/PET-CT was scored as 1 point. The total score of the bone-damage area was recorded as bone lesion level. Wherever detected, a fracture was recorded as 1. … Bone destruction in the skull, scapula, vertebrae, sternum/clavicle, ilium/pelvis/sacrum/pubis, and femur/humeral area detected by MR/CT/PET-CT scored 1 point, and the total score of the bone-damage area was recorded as bone lesion level. Wherever detected, a fracture was recorded as 1. …

The facial skeleton in patients with osteoporosis: a field for disease signs and treatment complications.

Osteoporosis affects all bones, including those of the facial skeleton. To date the facial bones have not drawn much attention due to the minimal probability of morbid fractures. Hearing and dentition loss due to osteoporosis has been reported. New research findings suggest that radiologic examination of the facial skeleton can be a cost-effective adjunct to complement the early diagnosis and the follow up of osteoporosis patients. Bone-mass preservation treatments have been associated with osteomyelitis of the jawbones, a condition commonly described as osteonecrosis of the jaws (ONJ). The fa

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… However, in the skull and the clavicle, bone forms directly in membranous connective tissue (intramembranous ossification, membranus bone). A brief look at the history of the skeleton may explain why [ 17 , 18 ]. … The surviving membranous bones in the head and part of the clavicle are fragments of the dermal shield. …

When "Myeloma" is not a Myeloma: a case report of malignant bone lymphoma.

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… The patient presented in our emergency department with generalized pain, fatigue, anorexia, and weight loss and a pathologic bone fracture in the right clavicle and left humerus in the previous month (Fig. 1 ). …

Multi-focal Lytic Lesions in a Patient with Myelofibrosis: A Case Report.

Myelofibrosis is a rare disorder that is classified as one of the myeloproliferative disorders. This particular disorder results in the abnormal proliferation of hematopoietic stem cells in the bone marrow. In some cases, such as ours, pathologic fractures can occur due to skeletal manifestations. We report on a rare finding of rapidly progressive lytic lesions in multiple regions throughout the body. This presentation of myelofibrosis behaving in a metastatic-like fashion has not been previously described.

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… A plain radiograph of the right shoulder identifying a permeative, lytic lesion of the distal clavicle and acromion (A). Two months later he was admitted to the hospital after a low energy fall and sustained a right intertrochanteric femur fracture. …

Could the Scapular Spike Sign Be Used as a Radiographic Proxy for Surgical Indications?

BACKGROUND: Scapula fractures are rare injuries (< 1% of fractures), and there remains substantial variability regarding decision-making for … 2 cm, angulation ≥ 45°, glenopolar angle ≤ 22°, or displaced double disruption of the shoulder with clavicle and scapular neck fracture. Open fractures and intraarticular fractures were excluded because they were not within the scope of this study. To answer our first question, we took measurements of the lateral border offset, medialization, and glenopola …

Is the Combination of Convex Compression for the Proximal Thoracic Curve and Concave Distraction for the Main Thoracic Curve Using Separate-rod Derotation Effective for Correcting Shoulder Balance and Thoracic Kyphosis?

BACKGROUND: Posterior correction of the proximal thoracic curve in patients with adolescent idiopathic scoliosis has been recommended to ach … ance, defined as the difference between the horizontal lines passing both superolateral tips of the clavicles (right-shoulder-up was positive), at the most recent follow-up. RESULTS: Convex compression with separate-rod derotation effectively corrected the proximal thoracic curve (41° ± 11° versus 17° ± 10°, mean difference 25° [95% CI 22° to 27°]; p < 0. …

Has the Affordable Care Act Been Associated with Increased Insurance Coverage and Early-stage Diagnoses of Bone and Soft-tissue Sarcomas in Adults?

BACKGROUND: Treatment of bone and soft-tissue sarcomas can be costly, and therefore, it is not surprising that insurance status of patients … .3), unspecified or other overlapping bone, articular cartilage, and joint and/or ribs, sternum, or clavicle (C40.8 to C40.9, C41.3, and C41.8 to C41.9), vertebral column (C41.2), pelvis (C41.4, C41.8, and C41.9), and soft-tissue sarcomas of the upper or lower extremity and/or pelvis (C49.1, C49.2, and C49.5). A total of 15,287 patients with newly diagnose …

Preoperative Assessment of Medication-Related Osteonecrosis of the Jaw Using [18F]fluoride Positron Emission Tomography (PET)/CT and [18F]fluorodeoxyglucose PET/MRI in Correlation with Histomorphometry and Micro-CT-A Prospective Comparative Study.

OBJECTIVES: The purpose of this study was to investigate the imaging characteristics of medication-related osteonecrosis of the jaw (MRONJ) using [18F]fluoride positron emission tomography/computed tomography (PET/CT) and [18F]fluorodeoxyglucose (FDG) PET/magnetic resonance imaging (MRI) for preoperative assessment and to correlate them with microarchitectural and histomorphometric data with respect to clinical findings. METHODS: Twelve patients (five female; mean age 75 ± 7.6 yr) with symptomatic MRONJ underwent both scans on the same day, and imaging findings were used to plan surgical inte

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… PET imaging started 40 min after injection, covering the area from the skull base to the clavicle in a single bed position, with a 30 min acquisition time. PET data were reconstructed using a 3D algorithm with specific parameters (matrix: 256 × 256, Gaussian filter: 4 mm). … PET data were acquired from the skull base to the clavicle in a two-minute acquisition using a 3D ordered subset expectation maximization algorithm (two iterations, 21 subsets, Gaussian filter 2.0 mm, matrix size 400 × 400, and slice thickness 2.0 mm). 2.5. …

Acquired Acromion Compromise, Including Thinning and Fragmentation, Is Not Associated With Poor Outcomes After Reverse Shoulder Arthroplasty.

BACKGROUND: Acquired acromial compromise, including thinning (less than 30% of the normal acromion) or fragmentation resulting from acromioh … T scan. The middle portion of the anterolateral acromion, situated lateral to the distal end of the clavicle, was crosschecked using the axial view. Measurements were subsequently performed from both coronal and sagittal views. In all, 29 patients with acromion compromise and 172 without acromion compromise met the inclusion and exclusion criteria. There w …

Osteitis Fibrosa Cystica: The Hideous Face of Hyperparathyroidism.

Osteitis fibrosa cystica (OFC), the skeletal scourge of advanced hyperparathyroidism, unveils itself as a relentless destroyer of bone architecture, leaving behind a landscape of fragility and deformity. In the shadow of chronic kidney disease, where mineral imbalances reign, this rare but devastating entity emerges as a silent tormentor. We present the case of a hemodialysis patient who fell victim to this sinister complication, manifesting with excruciating bone pain, pathological fractures, and radiographic and histological evidence of cystic osteolytic lesions. Biological assessments revea

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… The predominant tumor locations include the ribs, sternum, clavicle, pelvis, and the diaphyseal regions of long bones. Spinal involvement is rarer and may occur with or without associated neurological symptoms [ 8 ]. …