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Cystic angiomatosis of the bone appearing as intrathoracic lung masses: DISCUSSION (4)

osteolytic

The pathogenesis is not well understood but seems to favour the theory that these cystic lesions are the result of vascular malformations of congenital origin rather than representing true neoplasms , and that the osteolytic lesions are the result of pressure atrophy, hyperemia or progressive dilation of lymphatics with secondary bone resorption. The features in the present patient suggest that osteoclastic bone resorption may contribute to the osteolytic properties of these lesions – a dominant radiological manifestation of CAB. While an osteoblastic reaction has been documented in some patients , active osteoclastic bone resorption does not appear to have been emphasized in previous descriptions of the histology. More difficult to explain is the lack of biological control of this vascular network that allows cystic dilation and proliferation to occur. One possibility is that recanalization and subsequent distention of a pre-existing malformation occur, and only when symptoms result does this come to the attention of the patient. levitra super active plus

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