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'''Heterotopic ossification''' is an uncommon [[pathology]] specimen that may be considered a [[ditzel]]. | |||
==General== | |||
*Definition of ''heterotopic ossification'': bone formation in soft tissue.<ref name=pmid21611960>{{Cite journal | last1 = Leblanc | first1 = E. | last2 = Trensz | first2 = F. | last3 = Haroun | first3 = S. | last4 = Drouin | first4 = G. | last5 = Bergeron | first5 = E. | last6 = Penton | first6 = CM. | last7 = Montanaro | first7 = F. | last8 = Roux | first8 = S. | last9 = Faucheux | first9 = N. | title = BMP-9-induced muscle heterotopic ossification requires changes to the skeletal muscle microenvironment. | journal = J Bone Miner Res | volume = 26 | issue = 6 | pages = 1166-77 | month = Jun | year = 2011 | doi = 10.1002/jbmr.311 | PMID = 21611960 }} | |||
</ref> | |||
*Injury at site. | |||
*May be seen in the context of tetraplegia. | |||
Clinical:<ref name=pmid21611960/> | |||
*+/-Joint stiffness. | |||
*+/-Swelling. | |||
*+/-Pain. | |||
==Gross== | |||
*Firm nodule. | |||
==Microscopic== | |||
Features: | |||
*[[Lamellar bone]] - has layering/lines (best seen with polarized light). | |||
*+/-Skeletal muscle (within the marrow space). | |||
DDx: | |||
*[[Myositis ossificans]] - inflammation, cellular. | |||
*[[Osteosarcoma]], extraskeletal. | |||
*[[Osteochrondroma]] - at joint, has cartilage.{{fact}} | |||
*[[Pilomatricoma]] - may be extensively ossified.<ref name=pmid20439187>{{Cite journal | last1 = Ioannidis | first1 = O. | last2 = Stavrakis | first2 = T. | last3 = Cheva | first3 = A. | last4 = Papadimitriou | first4 = N. | last5 = Kotronis | first5 = A. | last6 = Kakoutis | first6 = E. | last7 = Makrantonakis | first7 = N. | title = Pilomatricoma of the arm with extensive ossification. | journal = Adv Med Sci | volume = 55 | issue = 2 | pages = 340-2 | month = | year = 2010 | doi = 10.2478/v10039-010-0010-y | PMID = 20439187 }}</ref> | |||
==Sign out== | |||
<pre> | |||
Lesion, Distal Phalanx of Right Little Finger, Excision: | |||
- Dermal ossification without cartilage in benign skin with a thick keratin layer. | |||
- NEGATIVE for evidence of malignancy. | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
LESION ("HETEROTOPIC OSSIFICATION"), RIGHT FEMUR, EXCISION: | |||
- BONE -- CONSISTENT WITH MUSCLE HETEROTOPIC OSSIFICATION. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
===Micro=== | |||
The sections show laminar bone with a marrow space containing adipose tissue and benign skeletal muscle. The osteocytes show no nuclear atypia. No mitotic activity is appreciated. | |||
==See also== | |||
*[[Ditzels]]. | |||
*[[Bone]]. | |||
*[[Cutaneous calcification]]. | |||
*[[Osseous metaplasia]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Ditzels]] |
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