Bone Lesions

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Bone lesions are often termed blastic or lytic. Blastic bone lesions are characterised by bone formation in excess of bone resorption. Lytic bone lesions are characterised by bone resorption in excess of bone formation. Normally these processes held maintain the integrity of the skeleton. In reality most bone lesions have both lytic and blastic components due to the intertwined nature of bone formation and resorption, and so it can be viewed as a spectrum. Prostate cancer lies on the blastic end of the spectrum, while multiple myeloma lies on the lytic end of the spectrum.

Diagnostic Schema

Malignancy is the most common type of bone lesions and is divided into primary and secondary lesions. Primary bone cancers are rare and include osteosarcoma, chondrosarcoma, and Ewing sarcoma. Secondary cancers can be solid or haematological.

Bone Lesions Schema

Benign bone lesions

• Paget's disease
• Osteoblastoma
• Chondroblastoma
• Bone cysts
• Giant cell tumour
• Fibrous dysplasia
• Bone islands

Malignant bone lesions

• Primary
  • Osteosarcoma
  • Chondrosarcoma
  • Ewing sarcoma
• Secondary
  • Solid cancers
    • Lung
    • Breast
    • Prostate
    • Renal
    • Melanoma
    • Thyroid
    • Carcinoid
  • Haematologic cancers
    • Multiple myeloma
    • Lymphoma
    • Leukaemia
    • POEMS syndrome
    • Systemic mastocytosis

Infectious

• Tuberculosis
• Endemic fungi
• Pyogenic osteomyelitis

Inflammatory

• Sarcoidosis
• Histiocytosis
• Crystal diseases

Other

• Hyperparathyroidism
• McCune Albright