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Mechanism of intramedullary high intensity area on T2-weighted magnetic resonance imaging in osteoid osteoma: A possible role of COX-2 expression

, : Mechanism of intramedullary high intensity area on T2-weighted magnetic resonance imaging in osteoid osteoma: A possible role of COX-2 expression. Pathology International 51(12): 933-937, December

To study the mechanism and pathophysiology of the development of intramedullary high intensity areas on T2-weighted magnetic resonance images (MRI) in cases of osteoid osteoma, we examined the expression of cyclooxygenase-2 (COX-2) in the nidus and surrounding bone tissues. In all six cases showing a marked intramedullary high intensity area adjacent to the nidus before surgery, neoplastic osteoblasts inside the nidus showed strong and diffuse COX-2 immunoreactivity. On the other hand, the osteoblasts rimming the surrounding reactive bone were COX-2 negative. In two cases examined by reverse transcription-polymerase chain reaction (RT-PCR), COX-2 mRNA was detected in abundance in the nidus. Histologically, vascular dilatation together with intramedullary edema was observed in all cases, which was probably reflected as a high intensity area on T2-weighted MRI. From our study, a high level of COX-2 expression in neoplastic osteoblasts in the nidus of osteoid osteomas may cause the secondary changes depicted by MRI.


DOI: 10.1046/j.1440-1827.2001.01305.x

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