Flashcards in Bones & Joints Deck (253)
Malignant fibrous histiocytoma: Histologic pitfall.
Thick, eosinophilic fibrillary deposits surrounding individual tumor cells may mimic tumor osteoid.
Malignant fibrous histiocytoma, giant-cell-rich vs. giant-cell tumor of bone.
Giant-cell lacks significant nuclear pleomorphism and atypical mitotic figures.
Giant-cell tumor of bone: Age group.
Skeletally mature young adults.
Giant-cell tumor of bone: Sites (4).
- Distal femur.
- Proximal tibia.
- Distal radius.
Giant-cell tumor of bone: Presentation.
Typical: Localized pain.
Sometimes: Pathologic fracture.
Giant-cell tumor of bone: Radiography
No sclerosis, no periosteal reaction.
Thin rim of bone separates expansile masses from soft tissue.
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.
Giant-cell tumor of bone: Cytogenetics.
Telomeric association involving 19q, 1p, 15p, or other chromosomes.
Giant-cell tumor of bone: Genes in which mutations are associated with more aggressive behavior (3).
The gene of hepatocyte-growth-factor receptor.
The gene of VEGF.
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.
Giant-cell tumor of bone vs. nonossifying fibroma (2).
- Usually metaphyseal.
- Peripheral sclerosis.
Giant-cell tumor of bone vs. brown tumor.
Brown tumor: Elevated serum calcium and PTH.