Flashcards in Bones & Joints Deck (253)
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180
Hemangioma of bone: Secondary changes (2).
Thrombosis leading to papillary endothelial hyperplasia: May be confused with angiosarcoma.
Epithelioid change in endothelial cells: May be confused with epithelioid hemangioendothelioma.
181
Hemangioma of bone: Histology of periphery.
Osteoclastic reabsorption of trabecular bone.
182
Massive osteolysis.
Aggressive angiomatosis affecting mainly the bones of the trunk of children and young adults.
183
Epithelioid hemangioendothelioma: Sites (3).
Lower extremities.
Axial skeleton.
Skull.
Usually multifocal within the same and/or different bones.
184
Epithelioid hemangioendothelioma: Radiography.
Discrete radiolucency with sclerotic rim.
185
Epithelioid hemangioendothelioma: Histology (4).
Epithelioid cells firm cords, nests, and anastomosing vessels.
Intracytoplasmic vacuoles that may contain erythrocytes.
Mixed inflammatory infiltrate that includes eosinophils.
Myxoid or chondroid-like stroma.
186
Epithelioid hemangioendothelioma: Immunohistochemistry (1,2).
Positive: Vascular markers.
Variable: EMA, cytokeratin.
187
Epithelioid hemangioendothelioma vs. angiosarcoma (3).
Angiosarcoma:
- More pleomorphism.
- More mitotic figures.
- Cells form tufts or bridges that span the lumens.
188
Epithelioid hemangioendothelioma vs. cartilaginous tumor.
The chondroid-like matrix of epithelioid hemangioendothelioma do not express S100 and may express vascular markers.
189
Solitary fibrous tumor: Sites (2).
Axial skeleton.
Lower extremities.
190
Solitary fibrous tumor: Histology.
Solid proliferation of spindle cells surrounding staghorn vessels.
Variable mitotic activity, nuclear atypia, necrosis.
191
Solitary fibrous tumor: Best predictor of malignancy.
Presence of more than 4 mitotic figures per 10 hpf.
192
Solitary fibrous tumor: Immunohistochemistry (2,2).
Positive: CD34, STAT6.
Negative: CD99, vimentin.
193
Solitary fibrous tumor: Special stain.
Reticulin stain reveals fibers around "pericytes".
194
Solitary fibrous tumor:
A. Mutation.
B. How best to detect the mutation.
A. Fusion of NAB2 and STAT6, both on 12q13.
B. IHC; FISH is not useful.
195
Solitary fibrous tumor: Differential diagnosis (6).
Metastatic solitary fibrous tumor.
Mesenchymal chondrosarcoma.
MFH.
Angioblastic meningioma.
Small-cell osteosarcoma.
Synovial sarcoma.
GIST.
196
Hemangioma of bone: Immunohistochemistry (4).
Positive: CD31, CD34, factor VIII, ERG.
197
Angiosarcoma: Associations (3).
Previous infarct of bone.
Chronic osteomyelitis.
Irradiation.
198
Fibrous dysplasia: Sites (7).
Monostotic form (90%): Skull, femur, tibia, ribs.
Polyostotic form: Femur, tibia, pelvis.
199
Fibrous dysplasia: Presentation.
Polyostotic form: Pain and recurrent fractures in childhood.
200
Fibrous dysplasia: Presentation according to anatomical site (3).
Skull: Facial deformities.
Long bones: Recurrent fractures with "shepherd's crook" deformity.
Ribs: Usually asymptomatic.
201
Fibrous dysplasia: Syndromes (3).
McCune-Albright.
Cherubism.
Mazabraud's.
202
McCune-Albright syndrome (4).
Fibrous dysplasia.
Precocious puberty.
Hyperthyroidism.
Café-au-lait macules ("coast of Maine").
203
Cherubism.
Fibrous dysplasia mainly affecting the jaws.
Many giant cells.
204
Mazabraud's syndrome.
Fibrous dysplasia.
Myxomas of soft tissue.
205
Fibrous dysplasia: Location in bone.
Intramedullary; diaphysis or metaphysis.
206
Fibrous dysplasia: Radiography.
Intramedullary mass causing cortical expansion.
207
Fibrous dysplasia: Locational variation.
Surface of bone: Fibrous dysplasia protuberans.
208
Fibrous dysplasia: Histology of trabeculae (3).
Resemble "Chinese letters".
No osteoblastic rimming.
Mineralization may form laminated structures that resemble cementoid bodies.
209
