Difference between revisions of "Osteoblastoma"

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| Width      =
| Width      =
| Caption    = Osteoblastoma. [[H&E stain]].
| Caption    = Osteoblastoma. [[H&E stain]].
| Micro      = anastomosing bony [[trabeculae]] with variable mineralization, osteoblast rimming, no nuclear atypia of osteocytes
| Micro      = anastomosing bony [[trabeculae]] with variable mineralization, osteoblastic rimming, no nuclear atypia of osteocytes
| Subtypes  =
| Subtypes  =
| LMDDx      = [[osteoid osteoma]], [[osteosarcoma]]
| LMDDx      = [[osteoid osteoma]], [[osteosarcoma]]
Line 22: Line 22:
| Prevalence =
| Prevalence =
| Bloodwork  =
| Bloodwork  =
| Rads      = > 1.5 cm (smaller lesions [[osteoid osteoma]]), often well-circumscribed, +/-cortical expansion, +/-cortical destruction
| Rads      = often >=2.0 cm (similar lesions 1-2 cm may be [[osteoid osteoma]]), often well-circumscribed, +/-cortical expansion, +/-cortical destruction
| Endoscopy  =
| Endoscopy  =
| Prognosis  = benign, may be locally destructive
| Prognosis  = benign, may be locally destructive
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*Uncommon.<ref name=pmid23362588>{{Cite journal  | last1 = Khan | first1 = IS. | last2 = Thakur | first2 = JD. | last3 = Chittiboina | first3 = P. | last4 = Nanda | first4 = A. | title = Large sacral osteoblastoma: a case report and review of multi-disciplinary management strategies. | journal = J La State Med Soc | volume = 164 | issue = 5 | pages = 251-5 | month =  | year =  | doi =  | PMID = 23362588 }}</ref>
*Uncommon.<ref name=pmid23362588>{{Cite journal  | last1 = Khan | first1 = IS. | last2 = Thakur | first2 = JD. | last3 = Chittiboina | first3 = P. | last4 = Nanda | first4 = A. | title = Large sacral osteoblastoma: a case report and review of multi-disciplinary management strategies. | journal = J La State Med Soc | volume = 164 | issue = 5 | pages = 251-5 | month =  | year =  | doi =  | PMID = 23362588 }}</ref>
*Typically age 15-20 and male (male:female = ~2:1).<ref name=pmid20345366>{{Cite journal  | last1 = Villalobos | first1 = CE. | last2 = Rybak | first2 = LD. | last3 = Steiner | first3 = GC. | last4 = Wittig | first4 = JC. | title = Osteoblastoma of the sternum--case report and review of the literature. | journal = Bull NYU Hosp Jt Dis | volume = 68 | issue = 1 | pages = 55-9 | month =  | year = 2010 | doi =  | PMID = 20345366 }}</ref>
*Typically age 15-20 and male (male:female = ~2:1).<ref name=pmid20345366>{{Cite journal  | last1 = Villalobos | first1 = CE. | last2 = Rybak | first2 = LD. | last3 = Steiner | first3 = GC. | last4 = Wittig | first4 = JC. | title = Osteoblastoma of the sternum--case report and review of the literature. | journal = Bull NYU Hosp Jt Dis | volume = 68 | issue = 1 | pages = 55-9 | month =  | year = 2010 | doi =  | PMID = 20345366 }}</ref>
**Very wide age range.<ref name=pmid8119712/>
**Very large age range.<ref name=pmid8119712/>
*Treatment: resection.<ref name=pmid20345366/>
*Treatment: resection.<ref name=pmid20345366/>


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*Bone.
*Bone.
**Vertebral column and sacrum - most common in one large series.<ref name=pmid8119712>{{Cite journal  | last1 = Lucas | first1 = DR. | last2 = Unni | first2 = KK. | last3 = McLeod | first3 = RA. | last4 = O'Connor | first4 = MI. | last5 = Sim | first5 = FH. | title = Osteoblastoma: clinicopathologic study of 306 cases. | journal = Hum Pathol | volume = 25 | issue = 2 | pages = 117-34 | month = Feb | year = 1994 | doi =  | PMID = 8119712 }}</ref>
**Vertebral column and sacrum - most common in one large series.<ref name=pmid8119712>{{Cite journal  | last1 = Lucas | first1 = DR. | last2 = Unni | first2 = KK. | last3 = McLeod | first3 = RA. | last4 = O'Connor | first4 = MI. | last5 = Sim | first5 = FH. | title = Osteoblastoma: clinicopathologic study of 306 cases. | journal = Hum Pathol | volume = 25 | issue = 2 | pages = 117-34 | month = Feb | year = 1994 | doi =  | PMID = 8119712 }}</ref>
*'''Must''' be greater 1.5 cm by definition.<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref>
*Size important as per WHO definition:<ref name=pmid25224389>{{Cite journal  | last1 = Yalcinkaya | first1 = U. | last2 = Doganavsargil | first2 = B. | last3 = Sezak | first3 = M. | last4 = Kececi | first4 = B. | last5 = Argin | first5 = M. | last6 = Basdemir | first6 = G. | last7 = Oztop | first7 = F. | title = Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients. | journal = Ann Diagn Pathol | volume = 18 | issue = 6 | pages = 319-25 | month = Dec | year = 2014 | doi = 10.1016/j.anndiagpath.2014.08.006 | PMID = 25224389 }}</ref> ‡
**>= 2.0 cm: osteoblastoma.
**<=1.0 cm: [[osteoid osteoma]].
**>1 cm and <2 cm: clinical and radiologic criteria should be considered.
 
Note:
*‡1.5 cm is a [[diagnostic size cutoff]] seen in older references.<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref>


===Radiology===
===Radiology===
Line 52: Line 58:
Features:<ref name=Ref_Sternberg4_285>{{Ref Sternberg4|285}}</ref>
Features:<ref name=Ref_Sternberg4_285>{{Ref Sternberg4|285}}</ref>
*Anastomosing bony [[trabeculae]] with:
*Anastomosing bony [[trabeculae]] with:
**Osteoblasts rimming.
**Osteoblastic rimming.
***Cells line-up at edge of bone.
***Cells line-up at edge of bone.


Line 65: Line 71:
Image:Osteoblastoma_-_high_mag.jpg | Osteoblastoma - high mag. (WC)
Image:Osteoblastoma_-_high_mag.jpg | Osteoblastoma - high mag. (WC)
Image:Osteoblastoma_-_low_mag.jpg | Osteoblastoma - low mag. (WC)
Image:Osteoblastoma_-_low_mag.jpg | Osteoblastoma - low mag. (WC)
Image:Bone Osteoblastoma LP PA.JPG|Osteoblastoma - low power. (SKB)
Image:Bone Osteoblastoma MP3 PA.JPG|Osteoblastoma - medium power. (SKB)
Image:Bone Osteoblastoma MP2 PA.JPG|Osteoblastoma - medium power. (SKB)
Image:Bone Osteoblastoma OsteoblasticRimming PA.JPG|Osteoblastoma - Higher power - Osteoblastic rimming. (SKB)
</gallery>
</gallery>


Latest revision as of 21:02, 23 February 2016

Osteoblastoma
Diagnosis in short

Osteoblastoma. H&E stain.
LM anastomosing bony trabeculae with variable mineralization, osteoblastic rimming, no nuclear atypia of osteocytes
LM DDx osteoid osteoma, osteosarcoma
Site bone - vertebral column typically, other bones
Clinical history usu. 15-20 years old, males > females
Symptoms usu. pain
Radiology often >=2.0 cm (similar lesions 1-2 cm may be osteoid osteoma), often well-circumscribed, +/-cortical expansion, +/-cortical destruction
Prognosis benign, may be locally destructive
Clin. DDx osteosarcoma

Osteoblastoma is benign primary bone tumour. It is grouped with the chondro-osseous tumours.

General

  • Benign bone tumour - that can be locally destructive and occasionally recurs.[1]
  • Uncommon.[2]
  • Typically age 15-20 and male (male:female = ~2:1).[3]
    • Very large age range.[1]
  • Treatment: resection.[3]

Gross

  • Bone.
    • Vertebral column and sacrum - most common in one large series.[1]
  • Size important as per WHO definition:[4] ‡
    • >= 2.0 cm: osteoblastoma.
    • <=1.0 cm: osteoid osteoma.
    • >1 cm and <2 cm: clinical and radiologic criteria should be considered.

Note:

Radiology

Features:

  • Often well-circumscribed, +/-cortical expansion, +/-cortical destruction.[1]

Note:

  • May be described as malignant by radiology.[1]

Microscopic

Features:[6]

  • Anastomosing bony trabeculae with:
    • Osteoblastic rimming.
      • Cells line-up at edge of bone.

Notes:

DDx:

Images

  • Osteoblastoma - high mag. (WC)

  • Osteoblastoma - low mag. (WC)

  • Osteoblastoma - low power. (SKB)

  • Osteoblastoma - medium power. (SKB)

  • Osteoblastoma - medium power. (SKB)

  • Osteoblastoma - Higher power - Osteoblastic rimming. (SKB)

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BONE, LEFT FEMUR, EXCISION:
- OSTEOBLASTOMA.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Lucas, DR.; Unni, KK.; McLeod, RA.; O'Connor, MI.; Sim, FH. (Feb 1994). "Osteoblastoma: clinicopathologic study of 306 cases.". Hum Pathol 25 (2): 117-34. PMID 8119712.
  2. ↑ Khan, IS.; Thakur, JD.; Chittiboina, P.; Nanda, A.. "Large sacral osteoblastoma: a case report and review of multi-disciplinary management strategies.". J La State Med Soc 164 (5): 251-5. PMID 23362588.
  3. ↑ 3.0 3.1 Villalobos, CE.; Rybak, LD.; Steiner, GC.; Wittig, JC. (2010). "Osteoblastoma of the sternum--case report and review of the literature.". Bull NYU Hosp Jt Dis 68 (1): 55-9. PMID 20345366.
  4. ↑ Yalcinkaya, U.; Doganavsargil, B.; Sezak, M.; Kececi, B.; Argin, M.; Basdemir, G.; Oztop, F. (Dec 2014). "Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients.". Ann Diagn Pathol 18 (6): 319-25. doi:10.1016/j.anndiagpath.2014.08.006. PMID 25224389.
  5. ↑ 5.0 5.1 Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 286. ISBN 978-0781740517.
  6. ↑ Mills, Stacey E; Carter, Darryl; Greenson, Joel K; Oberman, Harold A; Reuter, Victor E (2004). Sternberg's Diagnostic Surgical Pathology (4th ed.). Lippincott Williams & Wilkins. pp. 285. ISBN 978-0781740517.
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