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.

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]
  • Central nidus with surround sclerotic bone.[5]

Note:

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;[6] one needs some history to make the diagnosis.

DDx:

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. 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.
  5. 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. 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.
  7. URL: http://njms2.umdnj.edu/tutorweb/gross.htm. Accessed on: 7 May 2012.