골수염에 수반되는 Lamellar Nodular 골막반응에 대한 고찰 : 악성골종양과의 감별에 유용 = A Lamellar Nodular Periosteal Reaction Occuring in Osteomyelitis : Useful Finding for differentiation From Malignant bone tumor

다국어 초록 (Multilingual Abstract)

The first role of radiologist concerning with tumors or tumor like lesions of bone is to differentiate natures of their benignancy or malignancy. It si true that there were much of difficulties to distinguish osteomyelitis from malignant lesions radiographically. Although there is no single periosteal reaction that is unique for any disease process, we had confirmed certain periosteal reaction, that is, a lamellar nodular pattern, might aid to differentiate osteomyelitis from malignant bone tumor. The thirty patients of acute osteomyelitis in whom the follow-up studies were possible, eighteen patients with osteosarcoma and five patients with Ewing's sarcoma were rectrospectively evaluated : periosteal reactions in acute osteomyelitis(30 cases) undergo changes in their appearance that can be categorized : thin solid(18 cases), Codman's triangle(2 cases), no periosteal reaction(10 cases) in early phases ; lamellated(7 cases) and lamellar nodular patterns97 cases) in the course of the disease with pronounced reactive osteoblastic change in the medullary cavity ; in chronic forms914 cases0, cortical thickenign(11 cases0, cortical thickenign with involucrum(2 cases) and cortical thickening with sequstrum(1 case) were noted. In 18 cases of osteosarcoma were included : thin solid(1 cases), lamellated(2 cases), sunburst(5 cases), and Codman's triangle(2 cases); combined forms(5 cases)i. e., thin solid and lamellated(1case), lamellated and sunburst(2 cases), sunburst, and Codman's triangle(1 case), lamellated, sunburst and Comdman's triangle(1 case) ; and no periosteal reaction(3 cases0. 5 cases of ewing's sarcoma showed sunburst(1 case), interrupted periosteal reaction(1 case), and no periosteal reaction(3 cases). It is advised when a lamellar nodular periosteal reaction appeared with reactive osteoblastic reasction in the host bone, even thought their looking might be suggested to aggressivenss of thelesion, I shoud ge considered osteomyelitis rather than malignant bone tumors suchas osteosarcoma or Ewing's sarcoma.