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Anatomic pathology > Bones & Joints > Flashcards

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

Fibrous dysplasia: Histology of stroma.

Consists of fibroblastic spindle cells in a storiform pattern.