Metaphyseal fibrous defect

Metaphyseal fibrous defect
	Diagnosis in short
Synonyms	Nonossifying fibroma
Clinical history	Incidental radiograhic finding
Radiology	Lucent defect

General

Common
Non-neoplastic
Self-limited
Skeletally immature individuals, children and adolescent
Often small lesions discovered as an radiographic incidentaloma
Rarely seen as a pathologic specimen (should not be biopsied)

Synonyms

Nonossifying fibroma (larger but otherwise identical)
Fibrous cortical defect
Fibrous metaphyseal defect
Fibroxanthoma of bone

Site

Metaphysis of distal femur or proximal tibia (80%)
Cortical
Metaphysis
Long bones
Eccentric location

Gross

Firm, granular, brown to yellow to red

Microscopic

Spindle cells without cytologic atypia are arranged in a storiform pattern with scattered chronic inflammatory cells and benign giant cells. Foam cells and hemosiderin deposition are present. Mitoses are seen but cytologic atypia is absent.

Differential Diagnosis

Giant cell tumour of bone (epiphyseal location, occurs in adults)

Relevant Diagnostic Groups

Clinical
- FOG MACHINES - acronym for radiographically lytic bone lesions ^[1]
- 'Skeletal do not touch list' ^[2]
Pathologic
- Giant cell lesions of bone.
- Spindle cell lesions of bone.

Images

Image:

Bone Metaphyseal Fibrous Defect Medium Power

Bone Metaphyseal Fibrous Defect High Power

Stains

Not relevant.

IHC

Not relevant

Molecular

Not relevant

Syndromes

Jaffe-Campanacci syndrome ^[3]

Clinical history

Incidental radiographic finding
Pathologic fracture

Prognosis

Ideally should not be biopsied
Radiographically characteristic and benign
Ideally should not be treated or even biopsied
Spontaneously resolve by ossification
May resolve into a 'bone island'

Radiographic findings

Sharply demarcated, lucent, loculated, meta-diaphyseal lesion surrounded by a rim of sclerotic bone

Sign out

BONE; CURETTAGE: METAPHYSEAL FIBROUS DEFECT / NONOSSIFYING FIBROMA.

References

↑ URL: http://radiopaedia.org/articles/lytic-bone-lesion-mnemonic. Accessed on: October 14, 2014.
↑ URL: http://radiopaedia.org/articles/skeletal-do-not-touch-lesions-1. Accessed on: October 14, 2014.
↑ URL: http://www.bonetumor.org/plasma-cell-tumors/jaffe-campanacci-syndrome. Accessed on: October 14, 2014.

[1] URL: http://radiopaedia.org/articles/lytic-bone-lesion-mnemonic. Accessed on: October 14, 2014.

[2] URL: http://radiopaedia.org/articles/skeletal-do-not-touch-lesions-1. Accessed on: October 14, 2014.

[3] URL: http://www.bonetumor.org/plasma-cell-tumors/jaffe-campanacci-syndrome. Accessed on: October 14, 2014.

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