Evans Michael, Priddy Nathan, Tran Brandon
Radiology Department, Texas Children's Hospital, 6621 Fannin St, Houston, TX 77030.
Radiol Case Rep. 2020 May 7;15(7):955-960. doi: 10.1016/j.radcr.2020.04.046. eCollection 2020 Jul.
Osteomas are one of the most common benign fibro-osseous lesions affecting the sinonasal tract. Rarely osteomas have osteoblastoma-like areas histologically, which are often misdiagnosed radiologically and pathologically as osteoblastomas. We report the CT and MR imaging findings of 3 cases of osteoma with osteoblastomas-like features in pediatric patients, 1 initially diagnosed as an osteoblastoma. Only 5 case reports of osteoma with osteoblastoma-like features within the paranasal sinuses have been reported in the English literature to date using the PubMed search engine, none of which include pediatric patients. We review the typical zonal imaging characteristics of this rare presentation of osteoma and propose a distinct "sclerotic cap" sign to aide radiologists in differentiating osteomas with osteoblastoma-like features from the more common benign fibro-osseous lesions. Additionally, we address some radiologic-pathologic discrepancies in diagnosis between osteoblastoma and osteoma with osteoblatoma-like features.
骨瘤是影响鼻窦的最常见的良性纤维-骨病变之一。骨瘤在组织学上很少有骨母细胞瘤样区域,这些区域在放射学和病理学上常被误诊为骨母细胞瘤。我们报告了3例小儿骨瘤具有骨母细胞瘤样特征的CT和MR成像表现,其中1例最初被诊断为骨母细胞瘤。使用PubMed搜索引擎检索英文文献,迄今为止仅报道了5例鼻窦内具有骨母细胞瘤样特征的骨瘤病例报告,其中均未包括小儿患者。我们回顾了这种罕见的骨瘤表现的典型分区成像特征,并提出了一种独特的“硬化帽”征象,以帮助放射科医生将具有骨母细胞瘤样特征的骨瘤与更常见的良性纤维-骨病变区分开来。此外,我们还讨论了骨母细胞瘤与具有骨母细胞瘤样特征的骨瘤在诊断上的一些放射学-病理学差异。
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