Cytopathology of lytic lesions in bone can be helpful to diagnose infectious processes as well as neoplastic lesions. Tuberculosis, hydatid disease of bone are illustrated. Haemosiderosis of bone is also discussed,
Cytopathology ofOsteolytic Lesions in Bone Dr Genevieve Warner Learmonth Cytopathologist / Histopathologist, Cytopathology Laboratory, Groote Schuur Hospital University of Cape Town
Lytic lesions in Bone Lytic lesions are easily aspirated using a Jam Shedi needle. Most lytic lesions in bone are metastatic tumours. However infectious lesions of bone due to Tuberculosis and opportunistic infections due to HIV/AIDS are becoming more common in South Africa. Metabolic diseases can also present as lytic lesions in bone
Bony lesion: A shepherdess aged 60 yearshas difficulty in walking.X Ray: knee joint destroyed.Clinical Diagnosis: ?Aneurysmal Bone Cyst.Jam Shedi needle aspiratedclear fluid for Cytology.
Clear Fluid with scanty translucenthooklets and laminated membrane
Clinical Impression: Note extensive involvement of tibia, fibula, knee joint space, patella and soft tissues. No clinical signs of inflammation No sinus formation No pain No clinical evidence of parathyroid dysfunction. No renal disease
Lytic lesion in Clavicle. Scolices and Rostellum of hooklets
Histology of lytic lesion in clavicle, cross sectionof scolex, and laminated membrane
Life cycle of Echinococcusgranulosus in South Africa
TUBERCULOSIS in BONE35 year old woman presents withpain in lumbar area for months, thensudden paraplegiaX-rays show lytic lesions in lumbar vertebraeJam Shedi needle aspirate yields necroticmaterial.Cytology: Papanicolaou stain
Drug-susceptible TB and MDR-TB are spread the same way. TB germs are put into the air when a person with TB disease of the lungs or throat coughs, sneezes, speaks, or sings. These germs can float in the air for several hours, depending on the environment. Persons who breathe in the air containing these TB germs can become infected.