Gambaran radiologi lesi litik pada manus serial kasus

Background: Lytic lesion of the hand has been challenging in making the differential diagnoses. Tumor and tumor-like lesions present with a wide spectrum of radiological changes. Cases: The first patient is a 17 years old male presents with a painless lump in the left 5 th finger, suggested as benign bone tumor. The second patient is a 28 years old male presents with a painful lump in the left 3 rd finger,suggested as close fracture of the left metacarpal of the hand. The third patient is a 11 years old male presents with a painless lump and open wound in the right 2 nd finger,suggested as aggressive bone tumor. First patient‘s hand radiographs reveal expansile lytic lesions with narrow transitional zone, endosteal scaloping, ring and arc calcification, no perisoteal reaction, no cortical destruction in metadiaphysis of 5 th metacarpal and proximal phalanx of the left hand, suggested as primary benign bone tumor, suggested enchondroma. Histomorphology result suggested as enchondromatosis. Second patient‘s hand radiographs reveal expansile lytic lesion with narrow transitional zone and cortical destruction, no periosteal reaction, no calcification in epiphysis to diaphysis of 3 rd proximal phalanx of the left hand, suggested as primary benign bone tumor, suggested giant cell tumor. Histomorphology result suggested as benign giant cell tumors of the bone. Third patient’s hand radiographs reveal fusiform expansile lytic lesion with narrow transitional zone causes enlargement of diaphysis with cortical destruction and soft tissue mass, no periosteal reaction, no calcification in 2 nd proximal phalanx of right hand, suggested as tuberculous dactylitis, suggested non tuberculous osteomyelitis. Histomorphology result suggested as tuberculous process. Conclusion: Imaging and histomorphology play an important role in differentiating tumor and tumor-like lesions in bone. Recognition of imaging appearance of these lesions may help clinicians make a decision for the treatment.