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Difference between revisions of "Chondro-osseous tumours"
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*Direct entry (skin defect) - adults with diabetes. | *Direct entry (skin defect) - adults with diabetes. | ||
====Microscopic==== | |||
*PMNs. | *PMNs. | ||
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==Bone tumours== | ==Bone tumours== | ||
General: | General: | ||
*Metastasis:primary bone tumours = >20:1.<ref>WMSP P.632</ref> | *Metastasis:primary bone tumours = >20:1.<ref>WMSP P.632.</ref> | ||
==Giant cell tumour== | ==Giant cell tumour== | ||
General<ref>WMSP P.648</ref> | General<ref>WMSP P.648.</ref> | ||
*Approx. 5% of primary bone tumours. | *Approx. 5% of primary bone tumours. | ||
*Age 20-45 years. | *Age 20-45 years. | ||
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*May present with joint pain, immobility. | *May present with joint pain, immobility. | ||
Microscopic: | |||
*Mononuclear cells '''key feature'''. | *Mononuclear cells '''key feature'''. | ||
*Giant cells. | *Giant cells. | ||
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==Chondrosarcoma== | ==Chondrosarcoma== | ||
===Micro=== | ===Micro=== | ||
Features:<ref>IAV 26 | Features:<ref>IAV. 26 February 2009.</ref> | ||
*Abnormal cartilage. | *Abnormal cartilage. | ||
*Nuclear atypia. | *Nuclear atypia. | ||
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===Radiology=== | ===Radiology=== | ||
Features:<ref>WMSP P.650</ref> | Features:<ref>WMSP P.650.</ref> | ||
*Long bones, diaphyses. | *Long bones, diaphyses. | ||
*Destructive. | *Destructive. | ||
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===[[IHC]]=== | ===[[IHC]]=== | ||
Features:<ref>WMSP P.651</ref> | Features:<ref>WMSP P.651.</ref> | ||
*CD99 +ve (plasma membrane staining). | *CD99 +ve (plasma membrane staining). | ||
*CD45 -ve. | *CD45 -ve. | ||
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===Histology=== | ===Histology=== | ||
*Spindle cells with malignant features (e.g. nuclear membrane irregularies, marked nuclear | *Spindle cells with malignant features (e.g. nuclear membrane irregularies, marked nuclear size differences, mitoses) surrounded by delicate strands of osteoid. | ||
size differences, mitoses) surrounded by delicate strands of osteoid. | |||
**Osteoid on H&E: pink, homogenous, "glassy". | **Osteoid on H&E: pink, homogenous, "glassy". | ||
**Tumours typically very cellular - when compared to normal bone. | **Tumours typically very cellular - when compared to normal bone. | ||
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*Intracortical, radiolucent. | *Intracortical, radiolucent. | ||
===Microscopic=== | |||
Features: | |||
*Fibrous tumour. | *Fibrous tumour. | ||
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*Metastases. | *Metastases. | ||
**Most common tumours metastatic to bone (mnemonic: ''BLT with Ketchup & Pickles''): | **Most common tumours metastatic to bone (mnemonic: ''BLT with Ketchup & Pickles''): | ||
***Breast | ***Breast. | ||
***Liver | ***Liver. | ||
***Thyroid | ***Thyroid. | ||
***Kidney | ***Kidney. | ||
***Prostate. | ***Prostate. | ||
Epi.<ref>TN05 OR42</ref> | Epi.<ref>TN05 OR42.</ref> | ||
*Osteosarcoma -> 2nd decade. | *Osteosarcoma -> 2nd decade. | ||
*Ewing's ->5-20 yrs. | *Ewing's ->5-20 yrs. | ||
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==Malignant bone tumours by age== | ==Malignant bone tumours by age== | ||
Most common by age:<ref>TN05 OR42</ref> | Most common by age:<ref>TN05 OR42.</ref> | ||
*<1 year old - neuroblastoma. | *<1 year old - neuroblastoma. | ||
*1-10 years old - Ewing's of tubular bones. | *1-10 years old - Ewing's of tubular bones. | ||
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**Thought to be related to osteoid osteoma. | **Thought to be related to osteoid osteoma. | ||
**If in long bones often diaphyseal. | **If in long bones often diaphyseal. | ||
Ref.:<ref>TN05 OR41</ref><ref>[http://www.emedicine.com/RADIO/topic494.htm http://www.emedicine.com/RADIO/topic494.htm]</ref> | Ref.:<ref>TN05 OR41.</ref><ref>URL: [http://www.emedicine.com/RADIO/topic494.htm http://www.emedicine.com/RADIO/topic494.htm].</ref> | ||
==Brown cell tumour== | ==Brown cell tumour== | ||
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===Microscopy=== | ===Microscopy=== | ||
Features: | |||
*Fibrosis. | *Fibrosis. | ||