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Presented by Edward McCarthy, M.D. and prepared by Maryam Farinola M.D.
Case 3: A 25-year-old woman with sickle cell anemia had pain in her leg for several months.
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1. Question
Week 184: Case 3
A 25-year-old woman with sickle cell anemia had pain in her leg for several months. A radiograph demonstrated a fluffy calcification in her femur. A biopsy was performed./images/bone infarct 1.jpg
/images/bone infarct 2.jpg
/images/bone infarct 3.jpgCorrect
Answer: Bone infarct
Histology: Sickle cell patients frequently have bone infarction as a complication of their disease. The histologic features are dropout of osteocytes from the lacunae and marrow necrosis. Frequently, there is calcification of the necrotic marrow and reactive appositional new reparative bone on dead bone trabeculae.
Discussion: Although sickle cell anemia patients get osteomyelitis, there is no evidence of an acute inflammatory infiltrate in this biopsy.
The radiographic features show ring-like radiodensities which, although characteristic of a bone infarct, can also be seen in enchondromas. However, there is no cartilage in the biopsy.
Although there is some marrow fibrosis, there is no evidence that this is a fibrous neoplasm such as non-ossifying fibroma.
Incorrect
Answer: Bone infarct
Histology: Sickle cell patients frequently have bone infarction as a complication of their disease. The histologic features are dropout of osteocytes from the lacunae and marrow necrosis. Frequently, there is calcification of the necrotic marrow and reactive appositional new reparative bone on dead bone trabeculae.
Discussion: Although sickle cell anemia patients get osteomyelitis, there is no evidence of an acute inflammatory infiltrate in this biopsy.
The radiographic features show ring-like radiodensities which, although characteristic of a bone infarct, can also be seen in enchondromas. However, there is no cartilage in the biopsy.
Although there is some marrow fibrosis, there is no evidence that this is a fibrous neoplasm such as non-ossifying fibroma.
