Question

a 52-year-old male presents with low back pain and a history of bronchogenic carcinoma. radiographs of the lumbar spine reveal an osteoblastic vertebral body at l2 without anterior vertebral body scalloping, osseous expansion, or cortical thickening. what is the most likely diagnosis? a) giant cell tumor b) paget disease c) osteoblastic metastasis d) hodgkin lymphoma

Explanation:

1. Giant cell tumors are typically osteolytic, not osteoblastic, so option A is incorrect.
2. Paget disease of bone presents with osseous expansion and cortical thickening, which are not seen here, so option B is incorrect.
3. Bronchogenic carcinoma (especially adenocarcinoma subtype) commonly spreads to bone, and can produce osteoblastic (bone-forming) metastatic lesions. The patient's history of lung cancer plus the isolated osteoblastic vertebral lesion without features of other conditions matches this diagnosis.
4. Hodgkin lymphoma bone involvement is usually osteolytic or mixed, not purely osteoblastic, so option D is incorrect.

Answer:

C) osteoblastic metastasis