Multilayered periosteal reaction

Last revised by Leonardo Lustosa on 08 Feb 2022

Multilayered periosteal reaction, also known as a lamellated or onion skin periosteal reaction, demonstrates multiple concentric parallel layers of new bone adjacent to the cortex, reminiscent of the layers on an onion. The layers are thought to be the result of periods of variable growth 2 and indicate a pathological process of intermediate aggressiveness.

Pathology

It has been associated with:

See also

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Cases and figures

  • Figure 1: photograph - onion
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  • Figure 2: multilayered periosteal reaction (diagram)
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  • Figure 3: types of periosteal reactions
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  • Case 1: Ewing sarcoma with onion skin
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  • Case 2: Langerhan's cell histiocystosis
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  • Case 3: Langerhans cell histiocytosis
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  • Case 4: prostate cancer metastasis
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  • Case 5: Ewing sarcoma of the fibula
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  • Case 6: Ewing sarcoma - Iliac bone
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