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Presented by Dr. John Gross and prepared by Dr. Yembur Ahmad
This case talks about a 15-year-old male with a lytic tibial lesion.
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1. Question
This is a 15-year-old male with a lytic tibial lesion.
Diagnosis:
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The lesion is lytic with a rim of new bone walling it off. The lesion consists of bland storiform and spindle cells with admixed foamy macrophages and hemosiderin. One may see reactive woven bone in this lesion, which should not dissuade one from the diagnosis of non-ossifying fibroma.
Differential Diagnosis: Giant cell tumor of bone should involve skeletally mature patients, and is a lytic lesion which extends to the epiphysis and has a non-sclerotic border. Histologically it would consist of evenly-admixed neoplastic mononuclear cells and osteoclasts which frequently have over 50 nuclei per cell. Chondroblastoma would also be centered in the epiphysis, and is characterized by nuclei with grooves and grungy, chicken-wire type calcification. A primary bone sarcoma would demonstrate greater cytologic atypia and a more aggressive radiologic appearance.Incorrect
The lesion is lytic with a rim of new bone walling it off. The lesion consists of bland storiform and spindle cells with admixed foamy macrophages and hemosiderin. One may see reactive woven bone in this lesion, which should not dissuade one from the diagnosis of non-ossifying fibroma.
Differential Diagnosis: Giant cell tumor of bone should involve skeletally mature patients, and is a lytic lesion which extends to the epiphysis and has a non-sclerotic border. Histologically it would consist of evenly-admixed neoplastic mononuclear cells and osteoclasts which frequently have over 50 nuclei per cell. Chondroblastoma would also be centered in the epiphysis, and is characterized by nuclei with grooves and grungy, chicken-wire type calcification. A primary bone sarcoma would demonstrate greater cytologic atypia and a more aggressive radiologic appearance.
