医学影像英语每日读丨118.From Where Did the Soft Tissue Mass Arise

每天朗读一段医学影像学英语文章

朗读者：烧鸭老师

A soft tisue mass with a bony lesion should prompt the question of which is the origin. Although not absolutely certain, there are some helpful clues to help the differentiation between soft tissue tumor with bone invasion and bone tumor with soft tissue invasion.

A large soft tissue mass with smaller bone lesion generally indicates secondary bone invasion (exception: malignant lymphoma, Ewing sarcoma, etc.). the center position of the mass is also useful for determination of the primary site.

The tip of the destroyed bony cortex may also help the differentiation. Periosteal side tends to indicate bone tumor, and bone marrow side for soft tissue tumor.

Periosteal reaction is another clue to determine the primary site. Bone tumor typically elicits a periosteal reaction when extending into adjacent soft tissues. Soft tissue tumor usually destroys the periosteum and the bony cortex without eliciting a periosteal reaction(exception: myositis ossificans， etc.)

From: RSNA 2017

Notes

1. cortex  ['kɔrtɛks] n. n. [解剖] 皮质

2. periosteal    [,peri'ɔstiəl] adj. 骨膜的

3. elicits   引出

4. periosteum   [,pɛrɪ'ɑstɪəm] n. [解剖] 骨膜

5. myositis   [,maɪə'saɪtɪs] n. 肌炎

myositis ossificans  骨化性肌炎

翻译：妙然

【From Where Did the Soft Tissue Mass Arise 软组织肿块来源之鉴别】
骨骼周围的软组织肿块应明确其来源，虽然不容易完全确定，但也有一些线索有助于我们分辨其是软组织肿瘤侵犯了骨，还是骨肿瘤累及了软组织。
大的软组织肿块伴发小范围的骨骼病变，常提示继发性的骨损伤（除了：恶性的淋巴瘤、尤因肉瘤等）。肿块的中心部位也有助于判断病灶的原发部位。
骨皮质的损伤也有助于鉴别，靠近骨膜一侧常倾向于骨肿瘤，靠近骨髓一侧常倾向于软组织肿瘤。
骨膜反应是提示病灶原发部位的另一线索。当骨肿瘤侵犯邻近软组织的时候会产生典型的骨膜反应。但软组织肿瘤通常会破坏骨膜和骨皮质，不会有骨膜反应（除了：骨化性肌炎）。

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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