SUNRAY APPEARANCE

SUNRAY APPEARANCE

A pattern consisting of central disk with radiating calcified spicules projecting in manner of sunbeam,

LESIONS which show sunray appearance are:

1)Arterial/plexiform hemangioma.

6)Burkitts lymphoma

2)Chondrosarcoma.

5)Neuroblastoma.

3)Osteosarcoma.

4)Ewings sarcoma

ARTERIAL /PLEXIFORM
HEMANGIOMA

It is a type of congenital fistula.There is a pulsatile swelling of the arteries,veins become tortous and thick walled.

R/F(SITE)

Commonly found in mandible_inferior canal

Body and ramus of mandible.

The large lesion may cause cortical expansion with radiating spicules at the expanding periphery,occasionally producing the sunray or sunburst appearance.

SOAP BUBBLE/HONEY COMB

APPEARANCE

Well defined zone of radiolucency is present within which trabecular spaces get enlarged and the trabeculae themselves become coarse and thick.The lesion,therefore,presents typically a multicystic,soap bubble appearance.

SPOKES OF WHEEL APPEARANCE

The structure of the bone is changed in the affected area so that the trabeculae are arranged in a manner which has a rough resemblance to the spokes of wheels.

PHLEBOLITHS
Small area of calcifications occasionally within the surrounding soft tissues are seen.

EFFECT ON ADJACENT STRUCTURES

Root resorption .

Inferior alveolar canal.

Mandibular and mental foramen.

CHONDROSARCOMA

It develops from natural cartilage or benign cartilaginous tumour.

RADIOGRAPHIC FEATURES
Radiodensity-scleorotic or mixed.

Poorly defined borders.

Shape-round,ovoid or lobulated Sunray appearance-peripheral periosteal new bone may be present perpendicular to the orignal cortex giving sunray appearance.

SNOW LIKE APPEARANCE

It may be Multi loculated or develop as multiple radiolucency containing radioopaque foci.The centre radioopaque structure has been implied snow like features.

SOAP BUBBLE APPEARANCE

Large lobules of cartilage may give a radiolucent soap bubble appearance.

GROUND GLASS APPEARANCE

Diffuse calcifications may be superimposed on a bony background that resembles ground glass appearance.

SPECKLED APPEARANCE
Central radiolucent nidus which is probably cartilage,surrounded by calcifications Teeth may be band like,widening of PDL and resorption of roots. Condylar lesion. Mandibular lesion. Maxillary lesion.

OSTEOSARCOMA
Malignant tumour of the bone derived from osteoblast in which tumour cells contain high level 0f alkaline phosphatase

R/ F
There are types:

frankly osteolytic.

mixed

osteoblastic

OSTEOLYTIC
Ill defined margins. Moth eaten appearance. Spiking resorption of roots.

Sarcoma develop near maxillary sinus.

Lamina dura destroyed.

MIXED

Margins are not well defined.

Honey comb appearance:the bone within the radiolucent area of destruction may take the form of strands which may intersect or produce honey comb appearance.

OSTEOBLASTIC

Margins-ill defined.

Sunray appearance:if the tumour has invaded the periostium,many thin irregular spicules of new bone directed outwards and perpendicular to the surface of the lesion are seen producing sunray appearance.

GRANULAR APPEARANCE

Scleortic portion of mixed and opaque lesion may show vertical obliteration of trabecular pattern by new bone,impairing dence granular appearance.

CODMANS TRIANGLE
Radioopacities project from the cortex and mark the lateral extremities of the lesion referred as codmans triangle.its seen where the tumour breaks through the surface of the bone and its the result of seperation of the periostium from the surface of adjacent bone.

ONION PEEL APPEARANCE

Subperiosteal bone laid down in layers and it may take form of onion peel lamination.

EWINGS SARCOMA
R/F:

Site:posterior area of mandible.

Margins:ill defined. Sunray appearance:in advanced cases,where osteophyte formation is present,it may present as sunray appearance.

ONION PEEL APPEARANCE

If it penetrates the cortex,it may stimulate the periostium to produce thin layers. Pathologic fracture-dest, of lamina dura and bone.

BURKITTS LYMPHOMA
It

is lyphoreticular cell malignancy. B cell neoplasm. R/F: Sunray appearance-if periosteum is elevated,it will produce sunray appearance.

NEUROBLASTOMA
Rare

malignant tumor of the adrenal gland .It sometimes arises in the nerves or ganglia of the sympathetic system in the neck,thorac or abdomen.

MOTH EATEN APPEARANCE

Small

radiolucent foci scattered throughout the affected area.These small foci colaese and form amultilocular moth eaten appearance. Margins ill defined. Balloon like expansion with thinning of adjacent structure.

R /F
Sunburst

appearanceThere are spicules of bone within the soft tissue mass associated with bone destruction,these are roughly perpendicular to the surface of the bone and resemble sun burst appearance.

SPOKE WHEEL APPEARANCE

Spicules

of bone or trabeculae are arranged radially in a rough architecture of wheels or spokes. Mottled area of calcification is seen in some cases.

Presented

by:

amandeep sharma prefinal year roll no:02