Bone and Soft Tissue Tumors

  • Nicholas Morley
  • Ajit S. Paintal


Primary tumors of bone are classified according to matrix production and differentiation. The internal tumor matrix is traditionally identified initially on plain radiographs with characteristic types of tumor matrices, including osteoid, chondroid, or fibroblastic. The osteoid matrix is characterized radiographically by “cloudlike” bone formation. The chondroid matrix is traditionally described as “rings and arcs.” Fibroblastic matrix is typically radiolucent on radiographs.


Synovial sarcoma Chordoma Osteosarcoma Chondrosarcoma Malignant peripheral nerve sheath tumor Liposarcoma 


  1. 1.
    Kamide T, Nakada M, Hayashi Y, Uchiyama N, Hamada J. Intraparenchymal pneumocephalus caused by ethmoid sinus osteoma. J Clin Neurosci. 2009;16:1487–9.PubMedCrossRefGoogle Scholar
  2. 2.
    Davies AM. Primary bone tumors. Philadelphia: WB Saunders; 2008.CrossRefGoogle Scholar
  3. 3.
    Zhang Y, Rosenberg AE. Bone-forming tumors. Surg Pathol Clin. 2017;10:513–35.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Levine SM, Lambiase RE, Petchprapa CN. Cortical lesions of the tibia: characteristic appearances at conventional radiography. Radiographics. 2003;23:157–77.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Rosenthal DI, Hornicek FJ, Torriani M, Gebhardt MC, Mankin HJ. Osteoid osteoma: percutaneous treatment with radiofrequency energy. Radiology. 2003;229:171–5.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Miller SL, Hoffer FA. Malignant and benign bone tumors. Radiol Clin N Am. 2001;39:673–99.PubMedCrossRefPubMedCentralGoogle Scholar
  7. 7.
    Woertler K. Benign bone tumors and tumor-like lesions: value of cross-sectional imaging. Eur Radiol. 2003;13:1820–35.PubMedCrossRefPubMedCentralGoogle Scholar
  8. 8.
    Wilde GE, Gakhal MS. Radiological reasoning: imaging of a talar mass. Am J Roentgenol. 2011;196:WS47–52.CrossRefGoogle Scholar
  9. 9.
    Venugopal SB, Prasad S. Cytological diagnosis of osteoblastoma of cervical spine: a case report with review of literature. Diagn Cytopathol. 2015;43:218–21.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Rosenberg ZS, Lev S, Schmahmann S, Steiner GC, Beltran J, Present D. Osteosarcoma: subtle, rare, and misleading plain film features. Am J Roentgenol. 1995;165:1209–14.CrossRefGoogle Scholar
  11. 11.
    Yarmish G, Klein MJ, Landa J, Lefkowitz RA, Hwang S. Imaging characteristics of primary osteosarcoma: nonconventional subtypes. Radiographics. 2010;30:1653–72.PubMedCrossRefGoogle Scholar
  12. 12.
    Sathiyamoorthy S, Ali SZ. Osteoblastic osteosarcoma: cytomorphologic characteristics and differential diagnosis on fine-needle aspiration. Acta Cytol. 2012;56:481–6.PubMedCrossRefGoogle Scholar
  13. 13.
    VandenBussche CJ, Sathiyamoorthy S, Wakely PE, Ali SZ. Chondroblastic osteosarcoma: Cytomorphologic characteristics and differential diagnosis on FNA. Cancer Cytopathol. 2016;124:493–500.PubMedCrossRefGoogle Scholar
  14. 14.
    Lee KC, Davies AM, Cassar-Pullicino VN. Imaging the complications of osteochondromas. Clin Radiol. 2002;57:18–28.PubMedCrossRefGoogle Scholar
  15. 15.
    Ilaslan H, Sundaram M. Advances in musculoskeletal tumor imaging. Orthop Clin North Am. 2006;37:375–91.. viiPubMedCrossRefGoogle Scholar
  16. 16.
    Bernard SA, Murphey MD, Flemming DJ, Kransdorf MJ. Improved differentiation of benign osteochondromas from secondary chondrosarcomas with standardized measurement of cartilage cap at CT and MR imaging. Radiology. 2010;255:857–65.PubMedCrossRefGoogle Scholar
  17. 17.
    Eisenberg RL. Bubbly lesions of bone. Am J Roentgenol. 2009;193:W79–94.CrossRefGoogle Scholar
  18. 18.
    Rybak LD, Rosenthal DI, Wittig JC. Chondroblastoma: radiofrequency ablation—alternative to surgical resection in selected cases. Radiology. 2009;251:599–604.PubMedCrossRefGoogle Scholar
  19. 19.
    Kennedy N, Demos TC, Lomasney LM. Radiologic case study. Chondroblastoma with geographic bone destruction and a sclerotic rim. Orthopedics. 2009;32:542.PubMedCrossRefGoogle Scholar
  20. 20.
    Papaioannou G, Sebire NJ, McHugh K. Imaging of the unusual pediatric ‘blastomas’. Cancer Imaging. 2009;9:1–11.PubMedPubMedCentralCrossRefGoogle Scholar
  21. 21.
    Fanning CV, Sneige NS, Carrasco CH, Ayala AG, Murray JA, Raymond AK. Fine needle aspiration cytology of chondroblastoma of bone. Cancer. 1990;65:1847–63.PubMedCrossRefGoogle Scholar
  22. 22.
    Littrell LA, Wenger DE, Wold LE, Unni KK, White LM, et al. Radiographic, CT, and MR imaging features of dedifferentiated chondrosarcomas: a retrospective review of 174 de novo cases. Radiographics. 2004;24:1397–409.PubMedCrossRefGoogle Scholar
  23. 23.
    Dodd LG. Fine-needle aspiration of chondrosarcoma. Diagn Cytopathol. 2006;34:413–8.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Koplas MC, Lefkowitz RA, Bauer TW, Joyce MJ, Ilaslan H, Landa J, et al. Imaging findings, prevalence and outcome of de novo and secondary malignant fibrous histiocytoma of bone. Skelet Radiol. 2010;39:791–8.CrossRefGoogle Scholar
  25. 25.
    Hanrahan CJ, Christensen CR, Crim JR. Current concepts in the evaluation of multiple myeloma with MR imaging and FDG PET/CT. Radiographics. 2010;30:127–42.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Dimopoulos M, Terpos E, Comenzo RL, Bruno B, San Miguel J, Pérez-Simon JA, et al. International myeloma working group consensus statement and guidelines regarding the current role of imaging techniques in the diagnosis and monitoring of multiple myeloma. Leukemia. 2009;23:1545–56.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Mahnken AH, Wildberger JE, Gehbauer G, Bruno B, San Miguel J, Pérez-Simon JA, et al. Multidetector CT of the spine in multiple myeloma: comparison with MR imaging and radiography. Am J Roentgenol. 2002;178:1429–36.CrossRefGoogle Scholar
  28. 28.
    Angtuaco EJ, Fassas AB, Walker R, Sethi R, Barlogie B. Multiple myeloma: clinical review and diagnostic imaging. Radiology. 2004;231:11–23.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Taira AV, Herfkens RJ, Gambhir SS, Quon A. Detection of bone metastases: assessment of integrated FDG PET/CT imaging. Radiology. 2007;243:204–11.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Algra PR, Bloem JL, Tissing H, Falke TH, Arndt JW, Verboom LJ. Detection of vertebral metastases: comparison between MR imaging and bone scintigraphy. Radiographics. 1991;11:219–32.PubMedCrossRefGoogle Scholar
  31. 31.
    Taoka T, Mayr NA, Lee HJ, Simonson TM, Rezai K, et al. Factors influencing visualization of vertebral metastases on MR imaging versus bone scintigraphy. Am J Roentgenol. 2001;176:1525–30.CrossRefGoogle Scholar
  32. 32.
    Vanel D, Dromain C, Tardivon A. MRI of bone marrow disorders. Eur Radiol. 2000;10:224–9.PubMedCrossRefGoogle Scholar
  33. 33.
    Propeck T, Bullard MA, Lin J, Doi K, Martel W. Radiologic-pathologic correlation of intraosseous lipomas. Am J Roentgenol. 2000;175:673–8.CrossRefGoogle Scholar
  34. 34.
    Kind M, Stock N, Coindre JM. Histology and imaging of soft tissue sarcomas. Eur J Radiol. 2009;72:6–15.PubMedCrossRefGoogle Scholar
  35. 35.
    Ohguri T, Aoki T, Hisaoka M, Watanabe H, Nakamura K, Hashimoto H, et al. Differential diagnosis of benign peripheral lipoma from well-differentiated liposarcoma on MR imaging: is comparison of margins and internal characteristics useful? Am J Roentgenol. 2003;180:1689–94.CrossRefGoogle Scholar
  36. 36.
    Klijanienko J, Caillaud JM, Lagacé R. Fine-needle aspiration in liposarcoma: cytohistologic correlative study including well-differentiated, myxoid, and pleomorphic variants. Diagn Cytopathol. 2004;30:307–12.PubMedCrossRefGoogle Scholar
  37. 37.
    Dodd LG, Sara Jiang X, Rao K, Bui MM. Pleomorphic liposarcoma: a cytologic study of five cases. Diagn Cytopathol. 2015;43:138–43.PubMedCrossRefGoogle Scholar
  38. 38.
    Abreu E, Aubert S, Wavreille G, Gheno R, Canella C, Cotten A. Peripheral tumor and tumor-like neurogenic lesions. Eur J Radiol. 2013;82:38–50.PubMedCrossRefGoogle Scholar
  39. 39.
    Domanski HA, Akerman M, Engellau J, Gustafson P, Mertens F, Rydholm A. Fine-needle aspiration of neurilemoma (schwannoma). A clinicocytopathologic study of 116 patients. Diagn Cytopathol. 2006;34:403–12.PubMedCrossRefGoogle Scholar
  40. 40.
    Gupta K, Dey P, Vashisht R. Fine-needle aspiration cytology of malignant peripheral nerve sheath tumors. Diagn Cytopathol. 2004;31:1–4.PubMedCrossRefGoogle Scholar
  41. 41.
    Nishiguchi T, Mochizuki K, Ohsawa M, Inoue T, Kageyama K, Suzuki A, et al. Differentiating benign notochordal cell tumors from chordomas: radiographic features on MRI, CT, and tomography. Am J Roentgenol. 2011;196:644–50.CrossRefGoogle Scholar
  42. 42.
    Farsad K, Kattapuram SV, Sacknoff R, Ono J, Nielsen GP. Sacral chordoma. Radiographics. 2009;29:1525–30.PubMedCrossRefGoogle Scholar
  43. 43.
    Crapanzano JP, Ali SZ, Ginsberg MS, Zakowski MF. Chordoma: a cytologic study with histologic and radiologic correlation. Cancer. 2001;93:40–51.PubMedCrossRefGoogle Scholar
  44. 44.
    Siegel HJ, Sessions W, Casillas MA, Said-Al-Naief N, Lander PH, Lopez-Ben R. Synovial sarcoma: clinicopathologic features, treatment, and prognosis. Orthopedics. 2007;30:1020–5; quiz 6–7.PubMedCrossRefGoogle Scholar
  45. 45.
    O’Sullivan PJ, Harris AC, Munk PL. Radiological features of synovial cell sarcoma. Br J Radiol. 2008;81:346–56.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Ewing CA, Zakowski MF, Lin O. Monophasic synovial sarcoma: a cytologic spectrum. Diagn Cytopathol. 2004;30:19–23.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Nicholas Morley
    • 1
  • Ajit S. Paintal
    • 2
  1. 1.Department of RadiologyMarshfield ClinicMarshfieldUSA
  2. 2.Northshore Medical Group, Evanston HospitalEvanstonUSA

Personalised recommendations