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A Study of the Ossification in Bone Sarcoma

A Study of the Ossification in Bone Sarcoma A Study of the Ossification in Bone Sarcoma 1 D. B. Phemister , M.D. Chicago ↵ 1 Read before the Radiological Society of North America, at Cleveland, December, 1925. Excerpt OF the various pathological features presented by bone sarcomas, there are three of particular interest to the radiologist. These are bone destruction, new bone formation and the cytology of the predominating cell of the tumor. The first two are of interest because they can be studied in radiograms and aid greatly in the establishment of a diagnosis. The third is of interest because from the cellular structure it may be possible to predict to some extent the result to be expected from radiotherapy, particularly from the standpoint of palliation. Thus, in general, it is true that the more cellular and the less differentiated the sarcoma, the greater the response to radiotherapy and the better the immediate palliative result. Also, ossifying tumors show a resistance to treatment by irradiation that varies directly with the extent of ossification. This seems to be independent of the type of tumor bone formed, whether high or low. It may be dependent on the amount of lime salts deposited; the greater the deposit the greater the protection afforded the tumor cells. Elaborate classifications of bone sarcomas, based on cell or tissue type, are not after all of very great practical value, and the pathologist as well as the radiologist may be reasonably well satisfied when he has gone so far as to establish the diagnosis of primary malignancy of bone. Ossification in bone sarcoma is a phenomenon which varies greatly in different tumors and in different parts of the same tumor. There is always bone destruction, but not always new bone formation. Two types of new bone may be formed, namely, tumorous and non-tumorous, and it is usually possible to tell them apart in the radiograms. Tumorous bone, either in the primary lesion or in the metastasis, arises from tumor cells which possess an inherent tendency to ossify. Non-tumorous bone arises from osteoblasts of the normal bone in which the tumor develops. Tumor Bone. The tumor bone varies greatly in amount and arrangement in different tumors. In markedly ossifying lesions the entire tumor may be converted into bone, while in others the bulk of the lesion remains unossified. The earliest new bone is laid down in contact with the old bone and ossification proceeds toward the periphery of the tumor as it increases in size. In the markedly ossifying lesion the new bone is of a dense, spongy structure and does not radiate toward the periphery, except occasionally in its superficial portions. In the less markedly ossifying lesion the first bone to be laid down may be spongy in its arrangement, but the more recently formed bone that extends toward the periphery is usually deposited in rays. From a structural standpoint the new bone is generally so arranged as to support the tumor mass and not to strengthen the old bone from which it springs; hence the radiating arrangement. Copyrighted by the Radiological Society of North America, Inc. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Radiology Radiological Society of North America, Inc.

A Study of the Ossification in Bone Sarcoma

Phemister, D. B.
Radiology , Volume 7 (1): 17 – Jul 1, 1926
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Publisher
Radiological Society of North America, Inc.
Copyright
Copyright © 1926 by Radiological Society of North America
ISSN
1527-1315
eISSN
0033-8419
DOI
10.1148/7.1.17
Publisher site
See Article on Publisher Site

Abstract

A Study of the Ossification in Bone Sarcoma 1 D. B. Phemister , M.D. Chicago ↵ 1 Read before the Radiological Society of North America, at Cleveland, December, 1925. Excerpt OF the various pathological features presented by bone sarcomas, there are three of particular interest to the radiologist. These are bone destruction, new bone formation and the cytology of the predominating cell of the tumor. The first two are of interest because they can be studied in radiograms and aid greatly in the establishment of a diagnosis. The third is of interest because from the cellular structure it may be possible to predict to some extent the result to be expected from radiotherapy, particularly from the standpoint of palliation. Thus, in general, it is true that the more cellular and the less differentiated the sarcoma, the greater the response to radiotherapy and the better the immediate palliative result. Also, ossifying tumors show a resistance to treatment by irradiation that varies directly with the extent of ossification. This seems to be independent of the type of tumor bone formed, whether high or low. It may be dependent on the amount of lime salts deposited; the greater the deposit the greater the protection afforded the tumor cells. Elaborate classifications of bone sarcomas, based on cell or tissue type, are not after all of very great practical value, and the pathologist as well as the radiologist may be reasonably well satisfied when he has gone so far as to establish the diagnosis of primary malignancy of bone. Ossification in bone sarcoma is a phenomenon which varies greatly in different tumors and in different parts of the same tumor. There is always bone destruction, but not always new bone formation. Two types of new bone may be formed, namely, tumorous and non-tumorous, and it is usually possible to tell them apart in the radiograms. Tumorous bone, either in the primary lesion or in the metastasis, arises from tumor cells which possess an inherent tendency to ossify. Non-tumorous bone arises from osteoblasts of the normal bone in which the tumor develops. Tumor Bone. The tumor bone varies greatly in amount and arrangement in different tumors. In markedly ossifying lesions the entire tumor may be converted into bone, while in others the bulk of the lesion remains unossified. The earliest new bone is laid down in contact with the old bone and ossification proceeds toward the periphery of the tumor as it increases in size. In the markedly ossifying lesion the new bone is of a dense, spongy structure and does not radiate toward the periphery, except occasionally in its superficial portions. In the less markedly ossifying lesion the first bone to be laid down may be spongy in its arrangement, but the more recently formed bone that extends toward the periphery is usually deposited in rays. From a structural standpoint the new bone is generally so arranged as to support the tumor mass and not to strengthen the old bone from which it springs; hence the radiating arrangement. Copyrighted by the Radiological Society of North America, Inc.

Journal

Radiology – Radiological Society of North America, Inc.

Published: Jul 1, 1926

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