Radiology, Vol 159, 127-132, Copyright © 1986 by Radiological Society of North America
Sclerotic bone metastasis: radiologic-pathologic correlation
J Aoki, I Yamamoto, M Hino, C Shigeno, N Kitamura, H Itoh, K Torizuka, T Itoh and M Furuta
Radiographic appearances were correlated with histologic findings in
sclerotic bone metastases. For this purpose, undecalcified ground sections
were made from lumbar vertebrae obtained at 12 autopsies. The primary tumor
sites were the prostate gland in five cases, the breast in three, the lung
in two, the stomach in one, and the urinary bladder in one. After
Villanueva bone staining and methyl methacrylate embedding, 1-mm-thick
ground sections were made for low-kilovoltage contact radiography. In
sclerotic bone metastases, new bone is deposited on preexisting trabeculae
and in the intertrabecular spaces, forming lacy networks. The radiographic
indications of these histologic changes are trabecular thickening, marginal
obscurity (the "silhouette" sign), and homogeneous dense sclerotic change.
The silhouette sign in bone is a new concept, one that is helpful when the
changes in density are not reliable.
