Fig. 1.

Massive osteolysis with skip lesions in 38-year-old man.

Plain radiography of upper left extremity demonstrate almost complete osteolysis of left elbow (A), proximal radius (B), distal radius and ulna, wrist and carpal bones (C), proximal and distal metacarpals and phalanges (D). Bone scintigraphy showed increased activities in osteolysed region: elbow (E), wrist and carpal bones and phalanges (F). Sagittal MR images demonstrated that soft tissue masses and affected bones were hypointense to isointense with muscle on T1-weighted imaging (G) and were of heterogenous signal intensity on T2-weighted imaging (H). (I) Photomicrograph (Hematoxylin and eosin, original magnification × 200) revealed fibrous tissue containing proliferated vascular structures replaced with bone trabeculae and bone marrow.