Difference between revisions of "Osteoid osteoma"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Osteoid osteoma - low mag.jpg | |||
| Width = | |||
| Caption = Osteoid osteoma. [[H&E stain]]. | |||
| Micro = anastomosing bony [[trabeculae]] with variable mineralization, osteoblast rimming, no nuclear atypia of osteocytes | |||
| Subtypes = | |||
| LMDDx = [[osteoblastoma]], [[osteosarcoma]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[bone]] (femur > tibia > spine > elsewhere) | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = pain relieved by [[NSAIDs]] | |||
| Signs = | |||
| Symptoms = extremely painful | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = <= 2.0 cm (larger lesions ''[[osteoblastoma]]'') | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = [[osteosarcoma]] | |||
}} | |||
'''Osteoid osteoma''', abbreviated '''OO''', is benign primary [[bone tumour]]. It is grouped with the [[chondro-osseous tumours]]. | |||
It should '''not''' be confused with an ''[[osteoma]]''. | |||
==General== | |||
*Benign bone lesion. | |||
Clinical:<ref name=Ref_Sternberg4_285>{{Ref Sternberg4|285}}</ref> | |||
*Extremely painful. | |||
**Relieved by [[NSAIDs]]. | |||
==Gross== | |||
*Bone: femur > tibia > spine > elsewhere.<ref name=uthscsa>URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.</ref><ref name=radiologyassistant>URL: [http://www.radiologyassistant.nl/en/494e15cbf0d8d http://www.radiologyassistant.nl/en/494e15cbf0d8d]. Accessed on: 7 May 2012.</ref> | |||
*Most common location (in bone): diaphysis.<ref name=uthscsa>URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.</ref> | |||
*'''Must''' be less than 2 cm - 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> ‡ | |||
**Larger lesions with the same microscopy are ''[[osteoblastoma]]s''. | |||
*Central nidus with surround sclerotic bone.<ref name=pmid24093694>{{Cite journal | last1 = Boscainos | first1 = PJ. | last2 = Cousins | first2 = GR. | last3 = Kulshreshtha | first3 = R. | last4 = Oliver | first4 = TB. | last5 = Papagelopoulos | first5 = PJ. | title = Osteoid osteoma. | journal = Orthopedics | volume = 36 | issue = 10 | pages = 792-800 | month = Oct | year = 2013 | doi = 10.3928/01477447-20130920-10 | PMID = 24093694 }}</ref> | |||
Note: | |||
*‡ Previously, the [[diagnostic size cutoffs|diagnostic size cutoff]] was <=1.5 cm.<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref> | |||
Images: | |||
*[http://njms2.umdnj.edu/tutorweb/casegifs/ostostgross.jpg Osteoid osteoma - gross (umdnj.edu)].<ref>URL: [http://njms2.umdnj.edu/tutorweb/gross.htm http://njms2.umdnj.edu/tutorweb/gross.htm]. Accessed on: 7 May 2012.</ref> | |||
*[http://radiology.uthscsa.edu/CME/ELTXT/OOT/treatment.html Osteoid osteoma (uthscsa.edu)]. | |||
==Microscopic== | |||
Features:<ref name=Ref_Sternberg4_285>{{Ref Sternberg4|285}}</ref> | |||
*Anastomosing bony [[trabeculae]] with: | |||
**Variable mineralization. | |||
***Mineralization (calcium '''p'''hosphate) = '''p'''urple on [[H&E stain]]. | |||
**Osteoblast rimming. | |||
***Cells line-up at edge of bone. | |||
Note: | |||
*Histomorphologically near identical/indistinguishable from ''[[osteoblastoma]]'';<ref name=Ref_Sternberg4_286>{{Ref Sternberg4|286}}</ref> one needs some history to make the diagnosis. | |||
DDx: | |||
*[[Osteosarcoma]] - lace-like osteoid, no nidus. | |||
*[[Osteoblastoma]] - larger lesion, clinical features different. | |||
===Images=== | |||
<gallery> | |||
Image:Osteoid_osteoma_-_low_mag.jpg | Osteoid osteoma - low mag. (WC) | |||
Image:Osteoid osteoma - intermed mag.jpg | Osteoid osteoma - intermed. mag. (WC) | |||
Image:Osteoid_osteoma_-_high_mag.jpg | Osteoid osteoma - high mag. (WC) | |||
Image:Osteoid osteoma - very high mag.jpg | Osteoid osteoma - very high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://library.med.utah.edu/WebPath/COW/COW211.html Osteoid osteoma - CT scan (med.utah.edu)]. | |||
*[http://www.sciencephoto.com/images/imagePopUpDetails.html?pop=1&id=700030210&pviewid=&country=67&search=gschmeissners&matchtype=FUZZY Osteoid osteoma (sciencephoto.com)]. | |||
==Sign out== | |||
<pre> | |||
BONE, RIGHT FEMUR, EXCISION: | |||
- OSTEOID OSTEOMA. | |||
</pre> | |||
===Micro=== | |||
The sections show anastomosing bony trabeculae with variable mineralization and osteoblastic rimming. Multinucleated osteoclasts are scattered through the lesion. Hemosiderin-laden macrophages are present. No osteocyte nuclear atypia is apparent. Mitotic activity is not apparent. The osteoid is not lace-like. | |||
==See also== | |||
*[[Chondro-osseous tumours]]. | |||
*[[Bone]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Chondro-osseous tumours]] | |||
Latest revision as of 12:04, 20 June 2016
| Osteoid osteoma | |
|---|---|
| Diagnosis in short | |
 Osteoid osteoma. H&E stain. | |
|
| |
| LM | anastomosing bony trabeculae with variable mineralization, osteoblast rimming, no nuclear atypia of osteocytes |
| LM DDx | osteoblastoma, osteosarcoma |
| Site | bone (femur > tibia > spine > elsewhere) |
|
| |
| Clinical history | pain relieved by NSAIDs |
| Symptoms | extremely painful |
| Radiology | <= 2.0 cm (larger lesions osteoblastoma) |
| Clin. DDx | osteosarcoma |
Osteoid osteoma, abbreviated OO, is benign primary bone tumour. It is grouped with the chondro-osseous tumours.
It should not be confused with an osteoma.
General
- Benign bone lesion.
Clinical:[1]
- Extremely painful.
- Relieved by NSAIDs.
Gross
- Bone: femur > tibia > spine > elsewhere.[2][3]
- Most common location (in bone): diaphysis.[2]
- Must be less than 2 cm - as per WHO definition.[4] ‡
- Larger lesions with the same microscopy are osteoblastomas.
- Central nidus with surround sclerotic bone.[5]
Note:
- ‡ Previously, the diagnostic size cutoff was <=1.5 cm.[6]
Images:
Microscopic
Features:[1]
- Anastomosing bony trabeculae with:
- Variable mineralization.
- Mineralization (calcium phosphate) = purple on H&E stain.
- Osteoblast rimming.
- Cells line-up at edge of bone.
- Variable mineralization.
Note:
- Histomorphologically near identical/indistinguishable from osteoblastoma;[6] one needs some history to make the diagnosis.
DDx:
- Osteosarcoma - lace-like osteoid, no nidus.
- Osteoblastoma - larger lesion, clinical features different.
Images
Osteoid osteoma - low mag. (WC)
Osteoid osteoma - intermed. mag. (WC)
Osteoid osteoma - high mag. (WC)
Osteoid osteoma - very high mag. (WC)
www:
Sign out
BONE, RIGHT FEMUR, EXCISION: - OSTEOID OSTEOMA.
Micro
The sections show anastomosing bony trabeculae with variable mineralization and osteoblastic rimming. Multinucleated osteoclasts are scattered through the lesion. Hemosiderin-laden macrophages are present. No osteocyte nuclear atypia is apparent. Mitotic activity is not apparent. The osteoid is not lace-like.
See also
References
- ↑ 1.0 1.1 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. 285. ISBN 978-0781740517.
- ↑ 2.0 2.1 URL: http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html http://radiology.uthscsa.edu/CME/ELTXT/OOT/skeletallocation.html]. Accessed on: 7 May 2012.
- ↑ URL: http://www.radiologyassistant.nl/en/494e15cbf0d8d. Accessed on: 7 May 2012.
- ↑ 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.
- ↑ Boscainos, PJ.; Cousins, GR.; Kulshreshtha, R.; Oliver, TB.; Papagelopoulos, PJ. (Oct 2013). "Osteoid osteoma.". Orthopedics 36 (10): 792-800. doi:10.3928/01477447-20130920-10. PMID 24093694.
- ↑ 6.0 6.1 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.
- ↑ URL: http://njms2.umdnj.edu/tutorweb/gross.htm. Accessed on: 7 May 2012.