Osteoid osteoma

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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 <= 1.5 cm (larger lesion osteoblastoma)
Clin. DDx osteosarcoma

Osteoid osteoma, abbreviated OO, is benign primary bone tumour. It is grouped with the chondro-osseous tumours.

General

  • Benign bone lesion.

Clinical:[1]

  • Extremely painful.

Gross

  • Bone: femur > tibia > spine > elsewhere.[2][3]
  • Most common location (in bone): diaphysis.[2]
  • Must be <=1.5 cm by definition.[4]

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.

Note:

  • Histomorphologically near identical/indistinguishable from osteoblastoma;[4] one needs some history to make the diagnosis.

Images

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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. 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. 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.
  3. URL: http://www.radiologyassistant.nl/en/494e15cbf0d8d. Accessed on: 7 May 2012.
  4. 4.0 4.1 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.
  5. URL: http://njms2.umdnj.edu/tutorweb/gross.htm. Accessed on: 7 May 2012.