ĐỐI CHIẾU ĐẶC ĐIỂM MÔ BỆNH HỌC VỚI HÌNH ẢNH X QUANG VÀ MỘT SỐ YẾU TỐ LIÊN QUAN KHÁC Ở BỆNH NHÂN SARCOM XƯƠNG TRẺ EM

Abstract

Introduction: Osteosarcoma is a primary malignant bone tumor characterized by the direct production of osteoid or immature bone by tumor cells. Radiography plays a crucial role in detecting the presence of a tumor and guiding the biopsy for histopathological diagnosis. Histopathology helps confirm the diagnosis and classify tumor subtypes, which is essential for treatment planning. This study was conducted to correlate the histopathological features with radiographic findings and several related factors in pediatric osteosarcoma patients. Subjects and Methods: This was a cross-sectional descriptive study conducted on 78 patients under 16 years of age diagnosed with osteosarcoma based on the 2013 WHO classification. All cases were examined and diagnosed at the Department of Pathology and Molecular Biology, K Hospital – Tan Trieu Branch, from June 2015 to June 2020. Results: Conventional osteosarcoma predominantly affected males aged ≥10 years, typically involving the metaphyseal region of long bones. Radiographically, it presented as a mixed lytic and sclerotic lesion, with a distant metastasis rate of 15.1%. The telangiectatic type also showed male predominance and occurred in patients aged ≥10 years, commonly in the metaphyseal region, with radiographs showing purely lytic lesions. The small cell type occurred equally in males and females, typically in patients under 10 years old, and also involved the metaphyseal region with mixed lytic and sclerotic features. High-grade surface osteosarcoma was found in females aged ≥10 years, often affecting the diaphysis of long bones, with radiographs showing a surface-based lesion exhibiting mineralized osteoid formation. Conclusion: Osteosarcoma is more common in patients aged ≥10 years, with a male predominance and frequent involvement of the metaphyseal region of long bones. Conventional and small cell types present radiographically with mixed lytic–sclerotic patterns; telangiectatic type shows purely lytic lesions; and high-grade surface type, seen in females, presents as a mineralized surface-based mass. Identifying these subtype-specific characteristics is valuable for diagnosis and therapeutic decision-making.