Robert O. Cone

Histiocytoid hemangioma of bone: A benign lesion which may mimic angiosarcoma

Histiocytoid hemangioma is a related family of endothelial cell neoplasms, which was described by Rosai et al. [14] in 1979 and which encompasses a group of osseous, vascular and cutaneous neoplasms. These neoplasms bear a close resemblance to the angiosarcoma/hemangioendothelioma family of malignant neoplasms. A case of histiocytoid hemangioma is reported that presented as a multicentric osseous lesion and was initially diagnosed as angiosarcoma. The patient has had a remarkably benign course and at a later date developed skin and bone lesions diagnosed as angiolymphoid hyperplasia with eosinophilia identical to the initial lesion. This represents the first reported case of identical osseous and cutaneous lesions of the histiocytoid hemangioma group in the same patient and lends credence to Rosais concept. A review of the literature concerning angiosarcoma/hemangioendothelioma of the bone is presented with the conclusion that some lesions considered to represent multicentric angiosarcoma may represent the more benign histiocytoid hemangioma.

Digital arthrography in the evaluation of painful joint prostheses.

Digital arthrography was accomplished in 16 patients who had painful prostheses. In each instance, resulting arthrographic abnormalities were compared with those apparent on subsequent overhead radiographs. Results indicate the potential value of the digital technique in this clinical setting. The examination is easy to perform and rapid, and allows the examiner to view the changing images in the subtraction mode. Image manipulation and enhancement are also possible.

Investigation of a New Arthrographic Contrast Agent: Iotrol

A new nonionic dimer (Iotrol; Schering AG) and diatrizoate meglumine-diatrizoate sodium (Renografin-60; Squibb) were compared as arthrographic agents by injecting these substances into the knees of rabbits. Three experienced arthrographers judged the image quality produced by Iotrol to be superior to that of Renografin-60. Following animal sacrifice, histologic examination of the synovium revealed a significant difference in the inflammatory response evoked by the contrast agents: Iotrol caused less inflammation. In a second group of rabbits, methylprednisolone was subcutaneously injected 24 hours before the arthrographic studies. The methylprednisolone significantly reduced the inflammation in the Renografin-60 subgroup when compared with the nonmedicated counterparts. No significant effect was noted in a like comparison with Iotrol. In addition, the administration of methylprednisolone led to a deterioration of the radiographic images. Based upon our data, we believe Iotrol is superior to Renografin-60 as an arthrographic agent.