Difference between revisions of "Bizarre parosteal osteochondromatous proliferation"

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{{ Infobox diagnosis
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Name      = {{PAGENAME}}
| Image      =  
| Image      = Bone Bizzare Parosteal Osteochondromatous Proliferation MP2.jpg
| Width      =
| Width      =
| Caption    =  
| Caption    = Bizarre parosteal osteochondromatous proliferation. [[H&E stain]].
| Synonyms  =Nora lesion
| Synonyms  = Nora lesion
| Micro      =
| Micro      = disorganized cellular cartilage with a blue tint and patchy ossification matures into disorganized bone, proliferation of fibroblasts surrounds the bone/cartilage and occupies the intertrabecular spaces
| Subtypes  =
| Subtypes  =
| LMDDx      =
| LMDDx      = periosteal [[chondrosarcoma]], periosteal [[chondroma]], low grade parosteal [[osteosarcoma]], [[osteochondroma]]
| Stains    =
| Stains    =
| IHC        =
| IHC        =
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| Gross      =
| Gross      =
| Grossing  =
| Grossing  =
| Site      =
| Site      = [[bone]] (see ''[[chondro-osseous tumours]]'') - hands and feet
| Assdx      =
| Assdx      =
| Syndromes  =
| Syndromes  =
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| Signs      =
| Signs      =
| Symptoms  =
| Symptoms  =
| Prevalence =
| Prevalence = rare
| Bloodwork  =
| Bloodwork  =
| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
| Prognosis  =
| Prognosis  = benign/locally aggressive
| Other      =
| Other      =
| ClinDDx    =
| ClinDDx    =
| Tx        =
| Tx        =
}}
}}
'''Bizarre parosteal osteochondromatous proliferation''', also known as '''Nora lesion''', is a distinctive rare lesion of the hand or foot.<ref name=pmid19057740>{{Cite journal  | last1 = Gruber | first1 = G. | last2 = Giessauf | first2 = C. | last3 = Leithner | first3 = A. | last4 = Zacherl | first4 = M. | last5 = Clar | first5 = H. | last6 = Bodo | first6 = K. | last7 = Windhager | first7 = R. | title = Bizarre parosteal osteochondromatous proliferation (Nora lesion): a report of 3 cases and a review of the literature. | journal = Can J Surg | volume = 51 | issue = 6 | pages = 486-9 | month = Dec | year = 2008 | doi =  | PMID = 19057740 }}</ref>


==General==  
==General==  
A distinctive osteochondromatous proliferation of hands and feet.
A distinctive osteochondromatous proliferation of hands and feet.


==Population==
Population:
*Young adults
*Young adults.
*20s-30s
*Typically age (years) 20s and 30s.<ref name=pmid19057740/>
 
Prognosis:
*Benign.
*Locally aggressive.


==Location==
==Location==
Hands and feet
*Hands and feet.


==Radiology==
==Radiology==
Marginated wide based bony growth projecting into the soft tissues<ref>http://radiopaedia.org/articles/bizarre-parosteal-osteochondromatous-proliferation</ref>
*Marginated wide based bony growth projecting into the soft tissues.<ref>URL: [http://radiopaedia.org/articles/bizarre-parosteal-osteochondromatous-proliferation http://radiopaedia.org/articles/bizarre-parosteal-osteochondromatous-proliferation]. Accessed on: 29 November 2014.</ref>


==Gross==  
==Gross==  
*Nodule covered with glistening cartilage
*Nodule covered with glistening [[cartilage]].


==Microscopic==
==Microscopic==
Disorganized cellular cartilage with a blue tint and patchy ossification matures into disorganized bone.  A proliferation of fibroblasts surrounds the lesion and occupies intertrabecular spaces.
Features:
*Disorganized cellular cartilage with a blue tint and patchy ossification matures into disorganized bone.  *Proliferation of fibroblasts surrounds the lesion and occupies intertrabecular spaces.
 
DDx:
*Periosteal [[chondrosarcoma]].
*Periosteal [[chondroma]].
*Low grade parosteal [[osteosarcoma]].
*[[Osteochondroma]].


==DDX==
===Images===
*Chondrosarcoma
<gallery>
*Periosteal chondroma
Image:Bone BizzareParostealOsteochondromatousProliferation PA (2).JPG |Notice the disorganized blue tinted cartilage with partial ossification merging into mature bone.
*Osteochondroma
Image:Bone BizzareParostealOsteochondromatousProliferation PA.JPG |A loose proliferation of fibroblasts fills the spaces between the bony trabeculae.
*Low grade parosteal osteosarcoma
Image:Bone Bizzare Parosteal Osteochondromatous Proliferation MP.jpg|Medium power
Image:Bone Bizzare Parosteal Osteochondromatous Proliferation MP2.jpg|Medium power
Image:Bone Bizzare Parosteal Osteochondromatous Proliferation MP3.jpg|Medium Power
Image:Bone Bizzare Parosteal Osteochondromatous Proliferation HP.jpg|High power
</gallery>
www:
*[http://www.webpathology.com/slides-13/slides/Bone_BizarreParostealOsteochondromatousProlif_Xray.jpg BPOP - radiology (webpathology.com)].
*[http://pathologyoutlines.com/wick/bizarre%20parosteal%20osteochondromatous%20proliferation%20(bpop-%20no.jpg BPOP (pathologyoutlines.com)].


==Diangostic categories==
==Diagnostic categories==
*Cartilaginous neoplasms
*Cartilaginous neoplasms.
*Osteocartilaginous neoplasms
*Osteocartilaginous neoplasms.


==Stains==
==IHC==
==Molecular==
==Molecular==
t(1:17)(q32;q21)<ref>{{Cite journal  | last1 = Kuruvilla | first1 = S. | last2 = Marco | first2 = R. | last3 = Raymond | first3 = AK. | last4 = Al-Ibraheemi | first4 = A. | last5 = Tatevian | first5 = N. | title = BizarreParosteal Osteochondromatous Proliferation (Nora's lesion) with translocation t(1;17)(q32;q21): a case report and role of cytogenetic studies on diagnosis. | journal = Ann Clin Lab Sci | volume = 41 | issue = 3 | pages = 285-7 | month =  | year = 2011 | doi =  | PMID = 22075515 }}
*t(1:17)(q32;q21).<ref>{{Cite journal  | last1 = Kuruvilla | first1 = S. | last2 = Marco | first2 = R. | last3 = Raymond | first3 = AK. | last4 = Al-Ibraheemi | first4 = A. | last5 = Tatevian | first5 = N. | title = BizarreParosteal Osteochondromatous Proliferation (Nora's lesion) with translocation t(1;17)(q32;q21): a case report and role of cytogenetic studies on diagnosis. | journal = Ann Clin Lab Sci | volume = 41 | issue = 3 | pages = 285-7 | month =  | year = 2011 | doi =  | PMID = 22075515 }}</ref>
</ref>


==Sign out==
==Sign out==
==Prognosis==
*BIZARRE PAROSTEAL OSTEOCHONDROMATOUS PROLIFERATION (NORA LESION).
*Benign
*APPROPRIATE MARGIN STATEMENT.
*Locally aggressive


==See also==
==See also==
*[[Chondro-osseous tumours]].
==References==
==References==
{{Reflist|1}}
{{Reflist|1}}


==Introduction==
==External links==
==Specimen opening==
*[http://www.pathologyoutlines.com/topic/bonebizarreparosteal.html BPOP (pathologyoutlines.com)].
==Protocol==
 
===Protocol notes===
[[Category:Diagnosis]]
===Alternate approaches===
[[Category:Chondro-osseous tumours]]
==See also==
===Related protocols===
==References==
{{Reflist|1}}

Latest revision as of 02:43, 30 November 2014

Bizarre parosteal osteochondromatous proliferation
Diagnosis in short

Bizarre parosteal osteochondromatous proliferation. H&E stain.
Synonyms Nora lesion
LM disorganized cellular cartilage with a blue tint and patchy ossification matures into disorganized bone, proliferation of fibroblasts surrounds the bone/cartilage and occupies the intertrabecular spaces
LM DDx periosteal chondrosarcoma, periosteal chondroma, low grade parosteal osteosarcoma, osteochondroma
Site bone (see chondro-osseous tumours) - hands and feet
Prevalence rare
Prognosis benign/locally aggressive

Bizarre parosteal osteochondromatous proliferation, also known as Nora lesion, is a distinctive rare lesion of the hand or foot.[1]

General

A distinctive osteochondromatous proliferation of hands and feet.

Population:

  • Young adults.
  • Typically age (years) 20s and 30s.[1]

Prognosis:

  • Benign.
  • Locally aggressive.

Location

  • Hands and feet.

Radiology

  • Marginated wide based bony growth projecting into the soft tissues.[2]

Gross

Microscopic

Features:

  • Disorganized cellular cartilage with a blue tint and patchy ossification matures into disorganized bone. *Proliferation of fibroblasts surrounds the lesion and occupies intertrabecular spaces.

DDx:

Images

  • Notice the disorganized blue tinted cartilage with partial ossification merging into mature bone.

  • A loose proliferation of fibroblasts fills the spaces between the bony trabeculae.

  • Medium power

  • Medium power

  • Medium Power

  • High power

www:

Diagnostic categories

  • Cartilaginous neoplasms.
  • Osteocartilaginous neoplasms.

Molecular

  • t(1:17)(q32;q21).[3]

Sign out

  • BIZARRE PAROSTEAL OSTEOCHONDROMATOUS PROLIFERATION (NORA LESION).
  • APPROPRIATE MARGIN STATEMENT.

See also

References

  1. ↑ 1.0 1.1 Gruber, G.; Giessauf, C.; Leithner, A.; Zacherl, M.; Clar, H.; Bodo, K.; Windhager, R. (Dec 2008). "Bizarre parosteal osteochondromatous proliferation (Nora lesion): a report of 3 cases and a review of the literature.". Can J Surg 51 (6): 486-9. PMID 19057740.
  2. ↑ URL: http://radiopaedia.org/articles/bizarre-parosteal-osteochondromatous-proliferation. Accessed on: 29 November 2014.
  3. ↑ Kuruvilla, S.; Marco, R.; Raymond, AK.; Al-Ibraheemi, A.; Tatevian, N. (2011). "BizarreParosteal Osteochondromatous Proliferation (Nora's lesion) with translocation t(1;17)(q32;q21): a case report and role of cytogenetic studies on diagnosis.". Ann Clin Lab Sci 41 (3): 285-7. PMID 22075515.

External links

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