Pediatric Oncology
Education Materials

Benign/Malignant

Differential Diagnosis

Benign

Osteomyelitis

• Similar clinical presentation
• Usually due to TB

Eosinophilic granuloma or giant cell tumor

• Presents as lytic bone lesions

Malignant

Other primary bone sarcomas
(osteosarcoma and chondrosarcoma)

• Bone-forming tumors
• Lytic lesions with periosteal reactions

Lymphoma

• Causes bone destruction or sclerosis
• Usually no periosteal reaction in primary lymphoma
  

Metastatic neuroblastoma

Peripheral PNET

• Histologically similar to Ewings

Rhabdomyosarcoma

• Differentiate by presence of cell  surface glycoprotein p30/32 MIC2
• ES has characteristic translocation