Bizarre parosteal osteochondromatous proliferation

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

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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

Nodule covered with glistening cartilage.

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:

Periosteal chondrosarcoma.
Periosteal chondroma.
Low grade parosteal osteosarcoma.
Osteochondroma.

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]

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

References

↑ ^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.
↑ URL: http://radiopaedia.org/articles/bizarre-parosteal-osteochondromatous-proliferation. Accessed on: 29 November 2014.
↑ 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

BPOP (pathologyoutlines.com).

[pmid19057740-1] 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.

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