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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does The Radiography Report Indicate?

A 60-year-old previously healthy man presents with 2 to 3 months of back pain. Over the last 3 weeks, he has developed a cough and increasing fatigue. On examination he had evidence of pneumonia and was noted on radiography to have osteolytic lesions. Serum chemistry shows elevated calcium. Radiographs revealed a lytic bone lesion in the right posterior iliac crest as well as multiple lytic lesions of the skull and vertebral column. CBC is as follows: WBC 5.0 x 10³/mm³ Hgb 10.8 g/dl Hct 32.2% MCV 89 fL Platelet count of 135,000 What is the likely diagnosis?
Thu, 12 Jun 2014
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Radiologist,  's  Response
Hi,
Thanks for choosing healthcaremagic.
With the available reports and clinical condition, there are two likely possibilities. Firstly, it is likely to be a brown's tumor which is seen in cases of hyperparathyroidism. Most likely, it should be brown tumor which are seen in cases of hyperparathyroidism as some lab findings are also matching with it. The CBC reveals normal WBC count so unlikely to be infective. Elevated calcium levels also favour hyperparathyroidism.
Secondly, it can be a metastatic disease. Because there are multiple lesions involving the skull and bone as well it favours metastasis. As there is evidence of pneumonia without significant elevation of WBC count it can be primary neoplasm in the lung.
So, both of them are possibilities and require further investigations with CT Scan/bone scan.
Hope it sorts your problem.
Regards,
Dr. Pankaj Nagori
Specialist Radiologist
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What Does The Radiography Report Indicate?

Hi, Thanks for choosing healthcaremagic. With the available reports and clinical condition, there are two likely possibilities. Firstly, it is likely to be a brown s tumor which is seen in cases of hyperparathyroidism. Most likely, it should be brown tumor which are seen in cases of hyperparathyroidism as some lab findings are also matching with it. The CBC reveals normal WBC count so unlikely to be infective. Elevated calcium levels also favour hyperparathyroidism. Secondly, it can be a metastatic disease. Because there are multiple lesions involving the skull and bone as well it favours metastasis. As there is evidence of pneumonia without significant elevation of WBC count it can be primary neoplasm in the lung. So, both of them are possibilities and require further investigations with CT Scan/bone scan. Hope it sorts your problem. Regards, Dr. Pankaj Nagori Specialist Radiologist