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Metaphyseal fibrous defect (view source)
Revision as of 23:43, 18 October 2014
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = | | Name = Metaphyseal fibrous defect | ||
| Image = | | Image = Bone Metaphyseal Fibrous Defect High Power.JPG | ||
| Width = | | Width = | ||
| Caption = | | Caption = | ||
| Synonyms = nonossifying fibroma | | Synonyms = nonossifying fibroma, fibrous cortical defect, fibrous metaphyseal defect, fibroxanthoma of bone | ||
| Micro = | | Micro = | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = giant cell | | LMDDx = [[giant cell tumour of bone]], others | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 15: | Line 15: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = | | Site = [[metaphysis]] of [[bone]] - usu. lower extremity | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = incidental radiograhic finding | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = common | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = lucent defect | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = benign | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = | | Tx = none | ||
}} | }} | ||
{{ Infobox external links | |||
| Name = {{PAGENAME}} | |||
| EHVSC = | |||
| EHVSC_mult = | |||
| pathprotocols = | |||
| wikipedia = Nonossifying fibroma | |||
| pathoutlines = {{Pathologyoutlines|topic/bonemetaphysealfibrousdefect}} | |||
| rosaicollection = | |||
}} | |||
'''Metaphyseal fibrous defect''', abbreviated '''MFD''', is a common benign abnormality of the [[metaphysis]], classically seen in children and young adults. | |||
They are also known as '''fibrous cortical defect''', '''fibrous metaphyseal defect''', and '''fibroxanthoma of [[bone]]'''. '''Nonossifying fibroma''' is a larger lesion but otherwise identical. | |||
==General== | ==General== | ||
*Common | *Common. | ||
*Non-neoplastic | *Non-neoplastic. | ||
*Self-limited | *Self-limited. | ||
*Skeletally immature individuals, children and | *Skeletally immature individuals, children and adolescents. | ||
*Often small lesions discovered an radiographic incidentaloma | *Often small lesions discovered as an radiographic incidentaloma. | ||
*Rarely seen as a pathologic specimen (should not be biopsied). | |||
*May be seen in the context of ''Jaffe-Campanacci syndrome'' which may be a presentation of Neurofibromatosis Type 1.<ref>URL: [http://www.bonetumor.org/plasma-cell-tumors/jaffe-campanacci-syndrome http://www.bonetumor.org/plasma-cell-tumors/jaffe-campanacci-syndrome]. Accessed on: October 14, 2014.</ref><ref>{{Cite journal | last1 = Stewart | first1 = DR. | last2 = Brems | first2 = H. | last3 = Gomes | first3 = AG. | last4 = Ruppert | first4 = SL. | last5 = Callens | first5 = T. | last6 = Williams | first6 = J. | last7 = Claes | first7 = K. | last8 = Bober | first8 = MB. | last9 = Hachen | first9 = R. | title = Jaffe-Campanacci syndrome, revisited: detailed clinical and molecular analyses determine whether patients have neurofibromatosis type 1, coincidental manifestations, or a distinct disorder. | journal = Genet Med | volume = 16 | issue = 6 | pages = 448-59 | month = Jun | year = 2014 | doi = 10.1038/gim.2013.163 | PMID = 24232412 }} | |||
</ref> | |||
*Radiographic diagnosis. | |||
Clinical history: | |||
*Incidental radiographic finding. | |||
*Pathologic fracture. | |||
Treatment: | |||
*None (spontaneously resolve by ossification). | |||
**Diagnosis is part of the ''skeletal do not touch list''.<ref>URL: [http://radiopaedia.org/articles/skeletal-do-not-touch-lesions-1 http://radiopaedia.org/articles/skeletal-do-not-touch-lesions-1]. Accessed on: October 14, 2014.</ref> | |||
Notes: | |||
*May resolve into a ''bone island''. | |||
Clinical DDx: | |||
*''FOG MACHINES'' acronym for radiographically lytic bone lesions.<ref>URL: [http://radiopaedia.org/articles/lytic-bone-lesion-mnemonic http://radiopaedia.org/articles/lytic-bone-lesion-mnemonic]. Accessed on: October 14, 2014.</ref> | |||
==Gross== | ==Gross== | ||
Firm, granular, brown to yellow to red | *Firm, granular, brown to yellow to red. | ||
Site: | |||
*[[Metaphysis]] of distal femur or proximal tibia (80%). | |||
*Cortical. | |||
*Metaphysis. | |||
*Long bones. | |||
*Eccentric location. | |||
===Radiology=== | |||
*Sharply demarcated, lucent, loculated, meta-diaphyseal lesion. | |||
*Surrounded by a rim of sclerotic bone. | |||
<gallery> | |||
Image:NOF 1.jpg|Nonossifying fibroma. (WC) | |||
</gallery> | |||
==Microscopic== | ==Microscopic== | ||
Spindle cells without cytologic atypia are arranged in a storiform pattern | Features: | ||
*Spindle cells without cytologic atypia are arranged in a storiform pattern. | |||
*Scattered chronic inflammatory cells and benign [[giant cell]]s. | |||
*Foam cells and hemosiderin deposition are present. | |||
*Mitoses are seen but cytologic atypia is absent. | |||
DDx (microscopic): | |||
*[[Giant cell tumour of bone]] - [[epiphysis|epiphyseal]] location, occurs in adults. | |||
*Other [[giant cell lesions]] of bone. | |||
*[[Spindle cell lesion]]s of bone. | |||
==Images== | |||
<gallery> | |||
Image:Bone Metaphyseal Fibrous Defect Medium Power.JPG|Metaphyseal fibrous defect - intermediate magnification. | |||
Image:Bone Metaphyseal Fibrous Defect High Power.JPG|Metaphyseal fibrous defect - high magnification. | |||
</gallery> | |||
www: | |||
*[http://njms2.umdnj.edu/tutorweb/casegifs/nofhe1.jpg MFD (umdnj.edu)]. | |||
*[http://njms2.umdnj.edu/tutorweb/casegifs/nofhe2.jpg MFD (umdnj.edu)]. | |||
*[http://njms2.umdnj.edu/tutorweb/casegifs/nofhe1.jpg MFD (umdnj.edu)]. | |||
*[http://pathologyoutlines.com/wick/non-ossifying%20fibroma%20(metaphyseal%20fibrous%20defect)%20micro.jpg MFD (pathologyoutlines.com)]. | |||
==Stains== | ==Stains== | ||
*Not relevant. | |||
==IHC== | ==IHC== | ||
Not relevant | *Not relevant. | ||
==Molecular== | ==Molecular== | ||
*Not relevant. | |||
==Sign out== | ==Sign out== | ||
<pre> | |||
BONE, CURETTAGE: | |||
- METAPHYSEAL FIBROUS DEFECT / NONOSSIFYING FIBROMA. | |||
</pre> | |||
==See also== | ==See also== | ||
*[[Bone]]. | |||
==References== | ==References== | ||
{{Reflist|1}} | {{Reflist|1}} | ||
==External links== | |||
*[http://njms2.umdnj.edu/tutorweb/case8.htm A case of MFD (umdnj.edu)]. | |||
*[http://radiopaedia.org/articles/fibrous-cortical-defect Fibrous cortical defect (radiopaedia.org)]. | |||
*[http://radiopaedia.org/articles/non-ossifying-fibroma-1 Non-ossifying fibroma (radiopaedia.org)]. | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Bone]] | |||