Metaphyseal fibrous defect

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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

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

  • [1]
  • [2]
  • [3]
  • [4]
  • [File:Bone Metaphyseal Fibrous Defect Medium Power.JPG|thumb|Bone Metaphyseal Fibrous Defect Medium Power]
  • [File:Bone Metaphyseal Fibrous Defect High Power.JPG|thumb|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.

See also

References