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 | <= 2.0 cm (larger lesions osteoblastoma) |
| Clin. DDx | osteosarcoma |
Osteoid osteoma, abbreviated OO, is benign primary bone tumour. It is grouped with the chondro-osseous tumours.
It should not be confused with an osteoma.
General
- Benign bone lesion.
Clinical:[1]
- Extremely painful.
- Relieved by NSAIDs.
Gross
- Bone: femur > tibia > spine > elsewhere.[2][3]
- Most common location (in bone): diaphysis.[2]
- Must be less than 2 cm - as per WHO definition.[4] ‡
- Larger lesions with the same microscopy are osteoblastomas.
- Central nidus with surround sclerotic bone.[5]
Note:
- ‡ Previously, the diagnostic size cutoff was <=1.5 cm.[6]
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.
- Variable mineralization.
Note:
- Histomorphologically near identical/indistinguishable from osteoblastoma;[6] one needs some history to make the diagnosis.
DDx:
- Osteosarcoma - lace-like osteoid, no nidus.
- Osteoblastoma - larger lesion, clinical features different.
Images
Osteoid osteoma - low mag. (WC)
Osteoid osteoma - intermed. mag. (WC)
Osteoid osteoma - high mag. (WC)
Osteoid osteoma - very high mag. (WC)
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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
- ↑ 1.0 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.
- ↑ 2.0 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.
- ↑ URL: http://www.radiologyassistant.nl/en/494e15cbf0d8d. Accessed on: 7 May 2012.
- ↑ Yalcinkaya, U.; Doganavsargil, B.; Sezak, M.; Kececi, B.; Argin, M.; Basdemir, G.; Oztop, F. (Dec 2014). "Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients.". Ann Diagn Pathol 18 (6): 319-25. doi:10.1016/j.anndiagpath.2014.08.006. PMID 25224389.
- ↑ Boscainos, PJ.; Cousins, GR.; Kulshreshtha, R.; Oliver, TB.; Papagelopoulos, PJ. (Oct 2013). "Osteoid osteoma.". Orthopedics 36 (10): 792-800. doi:10.3928/01477447-20130920-10. PMID 24093694.
- ↑ 6.0 6.1 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.
- ↑ URL: http://njms2.umdnj.edu/tutorweb/gross.htm. Accessed on: 7 May 2012.