Bone - Revision history

Mark: image

2018-06-23T21:39:14Z

image

← Older revision		Revision as of 21:39, 23 June 2018
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	===Lamellar bone===		===Lamellar bone===
			[[File:Lamella bone H&E and under polarised light.gif\|thumb\|Animated GIF showing a photomicrograph of lamellar bone. The layers are accentuated under polarised light.]]
	*Collagen organized in layers (lamellae).		*Collagen organized in layers (lamellae).

Michael: /* Others */

2017-02-02T15:29:12Z

Others

← Older revision		Revision as of 15:29, 2 February 2017
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	A general DDx for cystic bone lesions is found on ''radipedia.com''.<ref>URL: [http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions]. Accessed on: 15 March 2011.</ref>		A general DDx for cystic bone lesions is found on ''radipedia.com''.<ref>URL: [http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions http://radipedia.com/WikiMedia/index.php?title=Benign_cystic_bone_lesions]. Accessed on: 15 March 2011.</ref>

			==Sequestrum==
			{{Main\|Sequestrum}}

	==Osteoarthritis==		==Osteoarthritis==

Michael: /* Inadequate */

2016-03-03T15:55:57Z

Inadequate

← Older revision		Revision as of 15:55, 3 March 2016
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	- Predominantly benign dense fibrous tissue with a small		- Predominantly benign dense fibrous tissue with a small
	amount of laminar bone, and minute fragment of marrow (<2 mm).		amount of laminar bone, and minute fragment of marrow (<2 mm).
			- Case will be sent to hematopathology for further assessment.
	~~Comment:~~
	~~This case~~ will be sent to hematopathology for ~~review~~.
	</pre>		</pre>

Michael: /* Inadequate */

2016-03-03T15:53:57Z

Inadequate

← Older revision		Revision as of 15:53, 3 March 2016
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	<pre>		<pre>
	Right Posterior Superior Iliac Spine, Bone Marrow Biopsy:		Right Posterior Superior Iliac Spine, Bone Marrow Biopsy:
	- ~~Insufficient for diagnosis (predominantly~~ benign dense fibrous		- Predominantly benign dense fibrous tissue with a small
	tissue with a small amount of laminar bone, and minute fragment		amount of laminar bone, and minute fragment of marrow (<2 mm).
	of marrow (<2 mm)).

	Comment:		Comment:
	~~A re-biopsy is suggested~~.		This case will be sent to hematopathology for review.
	</pre>		</pre>

Michael: /* Essentially normal */

2016-03-03T15:38:49Z

Essentially normal

← Older revision		Revision as of 15:38, 3 March 2016
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	- Case will be sent to hematology for consultation and correlation		- Case will be sent to hematology for consultation and correlation
	with other testing.		with other testing.
			</pre>

			====Inadequate====
			<pre>
			Right Posterior Superior Iliac Spine, Bone Marrow Biopsy:
			- Insufficient for diagnosis (predominantly benign dense fibrous
			tissue with a small amount of laminar bone, and minute fragment
			of marrow (<2 mm)).

			Comment:
			A re-biopsy is suggested.
	</pre>		</pre>

Michael: /* Bone marrow */

2016-03-03T15:33:47Z

Bone marrow

← Older revision		Revision as of 15:33, 3 March 2016
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	==Bone marrow==		==Bone marrow==
	{{Main\|Haematopoiesis}}		{{Main\|Haematopoiesis}}
			===General===
	*One of two ''[[primary lymphoid organs]]'' - the other one is the [[thymus]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref>		*One of two ''[[primary lymphoid organs]]'' - the other one is the [[thymus]].<ref>URL: [http://www.life.umd.edu/classroom/bsci423/song/Lab1.html http://www.life.umd.edu/classroom/bsci423/song/Lab1.html]. Accessed on: 28 March 2012.</ref>

			Bone marrow biopsy adequacy:<ref name=pmid16477878>{{Cite journal \| last1 = Rudzki \| first1 = Z. \| last2 = Partyła \| first2 = T. \| last3 = Okoń \| first3 = K. \| last4 = Stachura \| first4 = J. \| title = Adequacy of trephine bone marrow biopsies: the doctor and the patient make a difference. \| journal = Pol J Pathol \| volume = 56 \| issue = 4 \| pages = 187-95 \| month = \| year = 2005 \| doi = \| PMID = 16477878 }}</ref>
			*10 intertrabecular spaces or 10 mm.

			===Microscopic===
			One should see three cell lines:<ref>URL: [http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]. Accessed on: 28 March 2012.</ref>
			#Erythroid (red cells).
			#Myeloid (white blood cells).
			#Megakaryocytic (platelets).

			Adipose tissue:
	*Fat content (%) ~= age in years.<ref>IAV. 26 Feb 2009.</ref>		*Fat content (%) ~= age in years.<ref>IAV. 26 Feb 2009.</ref>
	**e.g. 60 year old will have 60% fatty replacement.		**e.g. 60 year old will have 60% fatty replacement.

	*One should see three cell lines:<ref>URL: [http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]. Accessed on: 28 March 2012.</ref>		Identifying the cell lines:<ref>[http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png]</ref>
	*#Erythroid (red cells).
	*#Myeloid (white blood cells).
	*#Megakaryocytic (platelets).

	Note: Lymphocytes are considered separately and typically spared in bone marrow failure.<ref>[http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]</ref>

	Identifying the lines:<ref>[http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png http://upload.wikimedia.org/wikipedia/commons/6/69/Hematopoiesis_%28human%29_diagram.png]</ref>
	#Megakaryocytes:		#Megakaryocytes:
	#*Big cells ~ 3x the size of a [[RBC]].		#*Big cells ~ 3x the size of a [[RBC]].
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	#*Reniform nucleus, i.e. kidney bean shaped nucleus.		#*Reniform nucleus, i.e. kidney bean shaped nucleus.

	~~===Images===~~		Note:
	<~~gallery~~>		*Lymphocytes are considered separately and typically spared in bone marrow failure.<ref>[http://emedicine.medscape.com/article/199003-overview http://emedicine.medscape.com/article/199003-overview]</ref>
	~~Image~~:~~Bone_marrow_WBC~~.~~JPG\| Myeloid line~~. ~~(WC)~~
	</~~gallery~~>
	====Organization====		====Organization====
	*Mature hematopoeitic cells at the centre (distant from bone).		*Mature hematopoeitic cells at the centre (distant from bone).
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	*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal \| last1 = Iancu \| first1 = D. \| last2 = Hao \| first2 = S. \| last3 = Lin \| first3 = P. \| last4 = Anderson \| first4 = SK. \| last5 = Jorgensen \| first5 = JL. \| last6 = McLaughlin \| first6 = P. \| last7 = Medeiros \| first7 = LJ. \| title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. \| journal = Arch Pathol Lab Med \| volume = 131 \| issue = 2 \| pages = 282-7 \| month = Feb \| year = 2007 \| doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 \| PMID = 17284114 }}</ref>		*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal \| last1 = Iancu \| first1 = D. \| last2 = Hao \| first2 = S. \| last3 = Lin \| first3 = P. \| last4 = Anderson \| first4 = SK. \| last5 = Jorgensen \| first5 = JL. \| last6 = McLaughlin \| first6 = P. \| last7 = Medeiros \| first7 = LJ. \| title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. \| journal = Arch Pathol Lab Med \| volume = 131 \| issue = 2 \| pages = 282-7 \| month = Feb \| year = 2007 \| doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 \| PMID = 17284114 }}</ref>
	**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)].		**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)].
			===Images===
			<gallery>
			Image:Bone_marrow_WBC.JPG\| Myeloid line. (WC)
			</gallery>

	===Sign out===		===Sign out===

Michael: /* Bone marrow */

2015-08-13T15:41:20Z

Bone marrow

← Older revision		Revision as of 15:41, 13 August 2015
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	*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal \| last1 = Iancu \| first1 = D. \| last2 = Hao \| first2 = S. \| last3 = Lin \| first3 = P. \| last4 = Anderson \| first4 = SK. \| last5 = Jorgensen \| first5 = JL. \| last6 = McLaughlin \| first6 = P. \| last7 = Medeiros \| first7 = LJ. \| title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. \| journal = Arch Pathol Lab Med \| volume = 131 \| issue = 2 \| pages = 282-7 \| month = Feb \| year = 2007 \| doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 \| PMID = 17284114 }}</ref>		*Immediately adjacent to the bone (paratrabecular)... is where [[follicular lymphoma]] is classically found.<ref name=pmid17284114>{{Cite journal \| last1 = Iancu \| first1 = D. \| last2 = Hao \| first2 = S. \| last3 = Lin \| first3 = P. \| last4 = Anderson \| first4 = SK. \| last5 = Jorgensen \| first5 = JL. \| last6 = McLaughlin \| first6 = P. \| last7 = Medeiros \| first7 = LJ. \| title = Follicular lymphoma in staging bone marrow specimens: correlation of histologic findings with the results of flow cytometry immunophenotypic analysis. \| journal = Arch Pathol Lab Med \| volume = 131 \| issue = 2 \| pages = 282-7 \| month = Feb \| year = 2007 \| doi = 10.1043/1543-2165(2007)131[282:FLISBM]2.0.CO;2 \| PMID = 17284114 }}</ref>
	**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)].		**Image: [http://www.flickr.com/photos/euthman/5691578596/in/set-72057594114099781 Paratrabecular follicular lymphoma (flickr.com)].

			===Sign out===
			====Essentially normal====
			<pre>
			Bone Marrow, Posterior Superior Iliac Spine, Biopsy:
			- Bone marrow with trilineage hematopoiesis.
			- Cellularity within normal limits for age.
			- Case will be sent to hematology for consultation and correlation
			with other testing.
			</pre>

	=Benign variants=		=Benign variants=

Michael: /* Sign out */

2014-06-19T15:08:12Z

Sign out

← Older revision		Revision as of 15:08, 19 June 2014
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	- MARROW SPACE WITH FIBROSIS AND SCATTERED LYMPHOCYTES AND PLASMA CELLS,		- MARROW SPACE WITH FIBROSIS AND SCATTERED LYMPHOCYTES AND PLASMA CELLS,
	COMPATIBLE WITH MILD CHRONIC OSTEOMYELITIS.		COMPATIBLE WITH MILD CHRONIC OSTEOMYELITIS.
			- NO MICROORGANISMS APPARENT WITH ROUTINE STAINS.
	- NEGATIVE FOR MALIGNANCY.		- NEGATIVE FOR MALIGNANCY.
	</pre>		</pre>

Michael: /* Chronic osteomyelitis */

2014-06-19T15:05:32Z

Chronic osteomyelitis

← Older revision		Revision as of 15:05, 19 June 2014
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	- SKIN ULCERATION.		- SKIN ULCERATION.
	- SOFT TISSUE SURGICAL MARGIN WITH FAT NECROSIS AND MUSCULAR ATROPHY.		- SOFT TISSUE SURGICAL MARGIN WITH FAT NECROSIS AND MUSCULAR ATROPHY.
			- NEGATIVE FOR MALIGNANCY.
			</pre>

			<pre>
			TRAPEZIUM, RIGHT HAND, REMOVAL:
			- DEGENERATIVE JOINT DISEASE.
			- MARROW SPACE WITH FIBROSIS AND SCATTERED LYMPHOCYTES AND PLASMA CELLS,
			COMPATIBLE WITH MILD CHRONIC OSTEOMYELITIS.
	- NEGATIVE FOR MALIGNANCY.		- NEGATIVE FOR MALIGNANCY.
	</pre>		</pre>

Michael: /* Aneurysmal bone cyst */ split out

2014-03-29T11:05:37Z

Aneurysmal bone cyst: split out

← Older revision		Revision as of 11:05, 29 March 2014
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	==Aneurysmal bone cyst==		==Aneurysmal bone cyst==
	*Abbreviated ''ABC''.		{{Main\|Aneurysmal bone cyst}}
	~~:''Also see [[giant cell reparative granuloma]]'' ([[AKA]] ''solid aneurysmal bone cyst'').~~

	~~===General===~~
	~~Features:<ref name=emed_abc>URL: [http://emedicine.medscape.com/article/1254784-overview http://emedicine.medscape.com/article/1254784-overview]. Accessed on: 4 February 2011.</ref>~~
	*Benign.
	**May grow rapidly.
	*Osteolysis -> cystic space -> filled with blood.
	*Relatively common; in children second only to [[osteosarcoma]].<ref name=pmid18157043>{{~~cite journal \|author=van den Berg H, Kroon HM, Slaar A, Hogendoorn P~~ \|~~title=Incidence of biopsy-proven~~ bone tumors in children: a report based on the Dutch pathology registration "PALGA" \|journal=J Pediatr Orthop \|volume=28 \|issue=1 \|pages=29–35 \|year=2008 \|pmid=18157043 \|doi=10.1097/BPO.0b013e3181558cb5 \|url=}}~~</ref>~~

	~~===Gross/radiologic===~~
	Features:<ref name=pmid22531523>{{Cite journal \| last1 = Parashari \| first1 = UC. \| last2 = Khanduri \| first2 = S. \| last3 = Upadhyay \| first3 = D. \| last4 = Bhadury \| first4 = S. \| last5 = Singhal \| first5 = S. \| title = Radiologic and pathologic correlation of aneurysmal bone cysts at unusual sites. \| journal = J Cancer Res Ther \| volume = 8 \| issue = 1 \| pages = 103-5 \| month = \| year = \| doi = 10.4103/0973-1482.95183 \| PMID = 22531523 }}</ref>
	*Air-fluid levels (radiology).
	*Usually metaphysis of long bones, but uncommonly the femur.
	*May have an "aggressive" appearance, i.e. erode bone.

	~~===Microscopic===~~
	~~Features:<ref name=emed_abc/>~~
	*Bony trabeculae ''or'' osteoid tissue.
	*Osteoclast [[giant cell]]s.
	**Multi-nucleated giant-cells with round randomly arranged nuclei.
	*Benign spindle cells (fibroblasts) - surround bone/adjacent to the giant cells - '''important'''.
	*Blood +/- surrounded by giant cells.

	~~DDx:~~
	*[[Giant cell tumour of bone]] - the nuclei of the cells surrounding the giant cells are similar to those in the giant cells (round nuclei).
	*[[Telangiectatic osteosarcoma]].
	*Other [[giant cell lesions]].

	~~====Images====~~
	~~<gallery>~~
	~~Image:Aneurysmal_bone_cyst_-_intermed_mag.jpg \| ABC - intermed. mag. (WC/Nephron)~~
	~~Image:Aneurysmal_bone_cyst_-_very_high_mag.jpg \| ABC - very high mag. (WC/Nephron)~~
	~~</gallery>~~
	~~www:~~
	*[http://www.webpathology.com/image.asp?n=4&Case=344 ABC - low mag. (webpathology.com)].
	*[http://www.webpathology.com/image.asp?n=5&Case=344 ABC - intermed. mag. (webpathology.com)].
	*[http://www.webpathology.com/image.asp?case=344&n=6 ABC - high mag. (webpathology.com)].

	==Myositis ossificans==		==Myositis ossificans==