Metaphyseal fibrous defect

Metaphyseal fibrous defect
	External resources
Wikipedia	Nonossifying fibroma
Pathology Outlines	topic/bonemetaphysealfibrousdefect

Metaphyseal fibrous defect
	Diagnosis in short
Synonyms	nonossifying fibroma, fibrous cortical defect, fibrous metaphyseal defect, fibroxanthoma of bone
LM DDx	giant cell tumour of bone, others
Site	metaphysis of bone - usu. lower extremity
Clinical history	incidental radiograhic finding
Prevalence	common
Radiology	lucent defect
Prognosis	benign
Treatment	none

Metaphyseal fibrous defect, abbreviated MFD, is a common benign abnormality of the metaphysis, classically seen in children and young adults.

They are also known as fibrous cortical defect, fibrous metaphyseal defect, and fibroxanthoma of bone. Nonossifying fibroma is a larger lesion but otherwise identical.

General

Common.
Non-neoplastic.
Self-limited.
Skeletally immature individuals, children and adolescents.
Often small lesions discovered as an radiographic incidentaloma.
Rarely seen as a pathologic specimen (should not be biopsied).
May be seen in the context of Jaffe-Campanacci syndrome which may be a presentation of Neurofibromatosis Type 1.^[1]^[2]
Radiographic diagnosis.

Clinical history:

Incidental radiographic finding.
Pathologic fracture.

Treatment:

None (spontaneously resolve by ossification).
- Diagnosis is part of the skeletal do not touch list.^[3]

Notes:

May resolve into a bone island.

Clinical DDx:

FOG MACHINES acronym for radiographically lytic bone lesions.^[4]

Gross

Firm, granular, brown to yellow to red.

Site:

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

Radiology

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

Nonossifying fibroma. (WC)

Microscopic

Features:

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

DDx (microscopic):

Giant cell tumour of bone - epiphyseal location, occurs in adults.
Other giant cell lesions of bone.
Spindle cell lesions of bone.

Images

Metaphyseal fibrous defect - intermediate magnification.
Metaphyseal fibrous defect - high magnification.

www:

Stains

Not relevant.

IHC

Not relevant.

Molecular

Not relevant.

Sign out

BONE, CURETTAGE: 
- METAPHYSEAL FIBROUS DEFECT / NONOSSIFYING FIBROMA.

References

↑ URL: http://www.bonetumor.org/plasma-cell-tumors/jaffe-campanacci-syndrome. Accessed on: October 14, 2014.
↑ Stewart, DR.; Brems, H.; Gomes, AG.; Ruppert, SL.; Callens, T.; Williams, J.; Claes, K.; Bober, MB. et al. (Jun 2014). "Jaffe-Campanacci syndrome, revisited: detailed clinical and molecular analyses determine whether patients have neurofibromatosis type 1, coincidental manifestations, or a distinct disorder.". Genet Med 16 (6): 448-59. doi:10.1038/gim.2013.163. PMID 24232412.
↑ URL: http://radiopaedia.org/articles/skeletal-do-not-touch-lesions-1. Accessed on: October 14, 2014.
↑ URL: http://radiopaedia.org/articles/lytic-bone-lesion-mnemonic. Accessed on: October 14, 2014.

External links

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

[2] Stewart, DR.; Brems, H.; Gomes, AG.; Ruppert, SL.; Callens, T.; Williams, J.; Claes, K.; Bober, MB. et al. (Jun 2014). "Jaffe-Campanacci syndrome, revisited: detailed clinical and molecular analyses determine whether patients have neurofibromatosis type 1, coincidental manifestations, or a distinct disorder.". Genet Med 16 (6): 448-59. doi:10.1038/gim.2013.163. PMID 24232412.

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

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

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