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Flashcards in Bones & Joints Deck (253)
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240

Malignant fibrous histiocytoma: Histologic pitfall.

Thick, eosinophilic fibrillary deposits surrounding individual tumor cells may mimic tumor osteoid.

241

Malignant fibrous histiocytoma, giant-cell-rich vs. giant-cell tumor of bone.

Giant-cell lacks significant nuclear pleomorphism and atypical mitotic figures.

242

Giant-cell tumor of bone: Age group.

Skeletally mature young adults.

243

Giant-cell tumor of bone: Sites (4).

Epiphyseal:

- Distal femur.
- Proximal tibia.
- Distal radius.
- Sacrum.

244

Giant-cell tumor of bone: Presentation.

Typical: Localized pain.

Sometimes: Pathologic fracture.

245

Giant-cell tumor of bone: Radiography

Lytic mass.

No sclerosis, no periosteal reaction.

Thin rim of bone separates expansile masses from soft tissue.

246

Giant-cell tumor of bone: Histology (3).

Bland, multinucleate, osteoclast-like giant cells.

Bland mononuclear cells in the background.

No cartilage unless there has been a fracture.

247

Giant-cell tumor of bone: Cytogenetics.

Telomeric association involving 19q, 1p, 15p, or other chromosomes.

248

Giant-cell tumor of bone: Genes in which mutations are associated with more aggressive behavior (3).

C-MYC.

The gene of hepatocyte-growth-factor receptor.

The gene of VEGF.

249

Giant-cell tumor of bone vs. giant-cell reparative granuloma (4).

Giant-cell reparative granuloma:

- Giant cells are unevenly distributed.
- Giant cells have fewer nuclei.
- More fibrotic stroma.
- Stromal cells are spindle shaped.

250

Giant-cell tumor of bone vs. nonossifying fibroma (2).

Nonossifying fibroma:

- Usually metaphyseal.
- Peripheral sclerosis.

251

Giant-cell tumor of bone vs. brown tumor.

Brown tumor: Elevated serum calcium and PTH.

252

Giant-cell tumor of bone: Behavior (2).

Most are benign, but rare benign ones exhibit pulmonary metastases due to embolizatio of tumor.

Malignant tumors can arise from benign tumors.