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===Lamellar bone===
===Lamellar bone===
[[File:Lamella bone H&E and under polarised light.gif|thumb|Animated GIF showing a photomicrograph of lamellar bone. The layers are accentuated under polarised light.]]
*Collagen organized in layers (lamellae).
*Collagen organized in layers (lamellae).


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==Bone marrow==
==Bone marrow==
{{Main|Haematopoiesis}}
{{Main|Haematopoiesis}}
===General===
*One of two ''[[primary lymphoid organs]]'' - the other one is the [[thymus]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref>
*One of two ''[[primary lymphoid organs]]'' - the other one is the [[thymus]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref>
Bone marrow biopsy adequacy:<ref name=pmid16477878>{{Cite journal  | last1 = Rudzki | first1 = Z. | last2 = Partyła | first2 = T. | last3 = Okoń | first3 = K. | last4 = Stachura | first4 = J. | title = Adequacy of trephine bone marrow biopsies: the doctor and the patient make a difference. | journal = Pol J Pathol | volume = 56 | issue = 4 | pages = 187-95 | month =  | year = 2005 | doi =  | PMID = 16477878 }}</ref>
*10 intertrabecular spaces or 10 mm.
===Microscopic===
One should see three cell lines:<ref>URL: [http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]. Accessed on: 28 March 2012.</ref>
#Erythroid (red cells).
#Myeloid (white blood cells).
#Megakaryocytic (platelets).
Adipose tissue:
*Fat content (%) ~= age in years.<ref>IAV. 26 Feb 2009.</ref>
*Fat content (%) ~= age in years.<ref>IAV. 26 Feb 2009.</ref>
**e.g. 60 year old will have 60% fatty replacement.
**e.g. 60 year old will have 60% fatty replacement.


*One should see three cell lines:<ref>URL: [http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]. Accessed on: 28 March 2012.</ref>
Identifying the cell lines:<ref>[http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png]</ref>
*#Erythroid (red cells).
*#Myeloid (white blood cells).
*#Megakaryocytic (platelets).
 
Note: Lymphocytes are considered separately and typically spared in bone marrow failure.<ref>[http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]</ref>
 
Identifying the lines:<ref>[http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png]</ref>
#Megakaryocytes:
#Megakaryocytes:
#*Big cells ~ 3x the size of a [[RBC]].
#*Big cells ~ 3x the size of a [[RBC]].
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#*Reniform nucleus, i.e. kidney bean shaped nucleus.
#*Reniform nucleus, i.e. kidney bean shaped nucleus.


===Images===
Note:
<gallery>
*Lymphocytes are considered separately and typically spared in bone marrow failure.<ref>[http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]</ref>
Image:Bone_marrow_WBC.JPG| Myeloid line. (WC)
</gallery>
====Organization====
====Organization====
*Mature hematopoeitic cells at the centre (distant from bone).
*Mature hematopoeitic cells at the centre (distant from bone).
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*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal  | last1 = Iancu | first1 = D. | last2 = Hao | first2 = S. | last3 = Lin | first3 = P. | last4 = Anderson | first4 = SK. | last5 = Jorgensen | first5 = JL. | last6 = McLaughlin | first6 = P. | last7 = Medeiros | first7 = LJ. | title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 2 | pages = 282-7 | month = Feb | year = 2007 | doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 | PMID = 17284114 }}</ref>
*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal  | last1 = Iancu | first1 = D. | last2 = Hao | first2 = S. | last3 = Lin | first3 = P. | last4 = Anderson | first4 = SK. | last5 = Jorgensen | first5 = JL. | last6 = McLaughlin | first6 = P. | last7 = Medeiros | first7 = LJ. | title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 2 | pages = 282-7 | month = Feb | year = 2007 | doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 | PMID = 17284114 }}</ref>
**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)].
**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)].
===Images===
<gallery>
Image:Bone_marrow_WBC.JPG| Myeloid line. (WC)
</gallery>
===Sign out===
====Essentially normal====
<pre>
Bone Marrow, Posterior Superior Iliac Spine, Biopsy:
- Bone marrow with trilineage hematopoiesis.
- Cellularity within normal limits for age.
- Case will be sent to hematology for consultation and correlation
  with other testing.
</pre>
====Inadequate====
<pre>
Right Posterior Superior Iliac Spine, Bone Marrow Biopsy:
- Predominantly benign dense fibrous tissue with a small
  amount of laminar bone, and minute fragment of marrow (<2 mm).
- Case will be sent to hematopathology for further assessment.
</pre>


=Benign variants=
=Benign variants=
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- SKIN ULCERATION.
- SKIN ULCERATION.
- SOFT TISSUE SURGICAL MARGIN WITH FAT NECROSIS AND MUSCULAR ATROPHY.
- SOFT TISSUE SURGICAL MARGIN WITH FAT NECROSIS AND MUSCULAR ATROPHY.
- NEGATIVE FOR MALIGNANCY.
</pre>
<pre>
TRAPEZIUM, RIGHT HAND, REMOVAL:
- DEGENERATIVE JOINT DISEASE.
- MARROW SPACE WITH FIBROSIS AND SCATTERED LYMPHOCYTES AND PLASMA CELLS,
  COMPATIBLE WITH MILD CHRONIC OSTEOMYELITIS.
- NO MICROORGANISMS APPARENT WITH ROUTINE STAINS.
- NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR MALIGNANCY.
</pre>
</pre>
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A general DDx for cystic bone lesions is found on ''radipedia.com''.<ref>URL: [http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions]. Accessed on: 15 March 2011.</ref>
A general DDx for cystic bone lesions is found on ''radipedia.com''.<ref>URL: [http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions]. Accessed on: 15 March 2011.</ref>
==Sequestrum==
{{Main|Sequestrum}}


==Osteoarthritis==
==Osteoarthritis==
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==Aneurysmal bone cyst==
==Aneurysmal bone cyst==
*Abbreviated ''ABC''.
{{Main|Aneurysmal bone cyst}}
:''Also see [[giant cell reparative granuloma]]'' ([[AKA]] ''solid aneurysmal bone cyst'').
 
===General===
Features:<ref name=emed_abc>URL: [http://emedicine.medscape.com/article/1254784-overview http://emedicine.medscape.com/article/1254784-overview]. Accessed on: 4 February 2011.</ref>
*Benign.
**May grow rapidly.
*Osteolysis -> cystic space -> filled with blood.
*Relatively common; in children second only to [[osteosarcoma]].<ref name=pmid18157043>{{cite journal |author=van den Berg H, Kroon HM, Slaar A, Hogendoorn P |title=Incidence of biopsy-proven bone tumors in children: a report based on the Dutch pathology registration "PALGA" |journal=J Pediatr Orthop |volume=28 |issue=1 |pages=29–35 |year=2008 |pmid=18157043 |doi=10.1097/BPO.0b013e3181558cb5 |url=}}</ref>
 
===Gross/radiologic===
Features:<ref name=pmid22531523>{{Cite journal  | last1 = Parashari | first1 = UC. | last2 = Khanduri | first2 = S. | last3 = Upadhyay | first3 = D. | last4 = Bhadury | first4 = S. | last5 = Singhal | first5 = S. | title = Radiologic and pathologic correlation of aneurysmal bone cysts at unusual sites. | journal = J Cancer Res Ther | volume = 8 | issue = 1 | pages = 103-5 | month =  | year =  | doi = 10.4103/0973-1482.95183 | PMID = 22531523 }}</ref>
*Air-fluid levels (radiology).
*Usually metaphysis of long bones, but uncommonly the femur.
*May have an "aggressive" appearance, i.e. erode bone.
 
===Microscopic===
Features:<ref name=emed_abc/>
*Bony trabeculae ''or'' osteoid tissue.
*Osteoclast [[giant cell]]s.
**Multi-nucleated giant-cells with round randomly arranged nuclei.
*Benign spindle cells (fibroblasts) - surround bone/adjacent to the giant cells - '''important'''.
*Blood +/- surrounded by giant cells.
 
DDx:
*[[Giant cell tumour of bone]] - the nuclei of the cells surrounding the giant cells are similar to those in the giant cells (round nuclei).
*[[Telangiectatic osteosarcoma]].
*Other [[giant cell lesions]].
 
====Images====
<gallery>
Image:Aneurysmal_bone_cyst_-_intermed_mag.jpg | ABC - intermed. mag. (WC/Nephron)
Image:Aneurysmal_bone_cyst_-_very_high_mag.jpg | ABC - very high mag. (WC/Nephron)
</gallery>
www:
*[http://www.webpathology.com/image.asp?n=4&Case=344 ABC - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=5&Case=344 ABC - intermed. mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=344&n=6 ABC - high mag. (webpathology.com)].


==Myositis ossificans==
==Myositis ossificans==
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==Fibrous dysplasia==
==Fibrous dysplasia==
*[[AKA]] ''osteitis fibrosa''.
*[[AKA]] ''osteitis fibrosa''.
===General===
{{Main|Fibrous dysplasia}}
Classification:
*''Monostotic'' - one bone involved, ~80% of cases.
*''Polyostotic'' - several bones involved, ~20% of cases.
**May be associated with [[McCune-Albright syndrome]].
 
===Microscopic===
Features:<ref>URL: [http://www.pathologypics.com/pictview.aspx?id=104 http://www.pathologypics.com/pictview.aspx?id=104]. Accessed on: 14 April 2011.</ref>
*Woven bone with odd irregular shapes - '''key feature'''.
**Described as "chinese characters".<ref>URL: [http://www.pathcases.com/bone_tumors_and_tumor.htm http://www.pathcases.com/bone_tumors_and_tumor.htm]. Accessed on: 31 May 2011.</ref>
*Fibrous tissue around bone.
 
Notes:
*No osteoblastic rimming.
 
DDx:
*[[Desmoplastic fibroma]] - has lamellar bone.
*Low grade [[fibrosarcoma]].
*[[Low-grade central osteosarcoma]].<ref name=inwards>{{cite journal |author=Inwards, CY |title=Low-grade central osteosarcoma versus fibrous dysplasia |journal=Pathology Case Reviews |volume=6 |issue=1 |pages=22-27 |year=2001 |pmid= |doi= |url= http://journals.lww.com/pathologycasereviews/Fulltext/2001/01000/Low_Grade_Central_Osteosarcoma_Versus_Fibrous.5.aspx }}</ref>
 
====Images====
<gallery>
Image:Fibrous_dysplasia_-_low_mag.jpg | Fibrous dysplasia - low mag. (WC/Nephron)
Image:Fibrous_dysplasia_-_intermed_mag.jpg | Fibrous dysplasia - intermed. mag. (WC/Nephron)
Image:Fibrous_dysplasia_-_high_mag.jpg | Fibrous dysplasia - high mag. (WC/Nephron)
</gallery>
www:
*[http://www.pathologypics.com/pictview.aspx?id=104 Fibrous dysplasia of bone - high mag. (pathologypics.com)].
*[http://www.pathologypics.com/BigPicViewer.aspx?PictureID=103 Fibrous dysplasia of bone - low mag. (pathologypics.com)].


==Desmoplastic fibroma==
==Desmoplastic fibroma==
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