Circumscribed lytic lesions of the thalassaemic skull

Abstract

Solitary or multiple circumscribed osteolytic areas are described in seven patients, selected from 250 patients with homozygous beta-thalassaemia (Cooley's anaemia). On X-ray examinations, these areas appear as purely osteolytic lesions with well-defined margins not associated with sclerosis. The possible mechanisms are discussed.

Skeletal radiological findings in thalassemia major

“…Initially, radiography may show only a slight thickening of the vault and the bones look "hazy" and "sandy" with increased poros ity due to granular osteoporosis. At a later stage, the skull bones have a more spongy out line but well-circumscribed solitary or multiple lytic lesions may be also occasionally seen 19 .…”

Bone Disease in Β‐thalassaemia Major

“…Radiological changes of these deformities are striking. In the case of the skull there is osteopenia, with widening of the diploic space, thinning or virtual disappearance of the outer table, new bone formation to the inner table (hair‐on‐end) appearance, absence of paranasal sinuses, and pneumatization with solitary or multiple circumscribed osteolytic areas of the skull ( Orzincolo et al , 1998 ).…”

Hematologic Bone Diseases

“…Hypertelorism resulting from marrow proliferation in the frontal bones may be seen. Diploic marrow proliferation causes the calvaria to demonstrate varying degrees of the "hair-on-end" appearance, 35 terminating abruptly at the external occipital protuberance and not extending into the petrous portion of the occipital bone (the petrous portion of the occipital bone has no active marrow). Infarctions are distinctly unusual.…”