Sandbox: Bone DDx: Difference between revisions

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* 10-20 yo patients
* 20-30 yo female
* Asymptomatic incidental finding on imaging studies
* Bone pain and swelling
* Pathologic fracture
* Paget disease of bone


* Facial asymmetry, rib deformities, and leg-length discrepancy as late complication
* Localised bone tenderness


* Located at the craniofacial bones, ribs, and proximal femur
* Epiphyses of the long bones  
* Solitary expansile eccentrically-placed lytic lesion
* Intratumoral hemorrhage present
* Tumor extends into the subchondral plate


* Ground-glass matrix
* Uniform and regular distribution of multinucleated giant cells and mononuclear stromal cells
* Completely lucent or bubbly cystic expansile benign lesion
* Hemorrhage, necrosis, and hemosiderin deposition
* Well circumscribed with no periosteal reaction
* Elevated mitotic figures


* Fibrocellular matrix of immature collagen
* Contains small irregularly shaped trabeculae of woven bone
* "Chinese characters" appearance
* Trabeculae not rimmed by osteoblasts
* Cartilaginous islands


* GNAS1 gene 10
acid phosphatase +ve
alpha-1-antitrypsin +ve
alpha-1-antichymotrypsin +ve
Ki-67 +ve

Revision as of 15:43, 24 November 2015

  • 20-30 yo female
  • Bone pain and swelling
  • Pathologic fracture
  • Paget disease of bone
  • Localised bone tenderness
  • Epiphyses of the long bones
  • Solitary expansile eccentrically-placed lytic lesion
  • Intratumoral hemorrhage present
  • Tumor extends into the subchondral plate
  • Uniform and regular distribution of multinucleated giant cells and mononuclear stromal cells
  • Hemorrhage, necrosis, and hemosiderin deposition
  • Elevated mitotic figures


acid phosphatase +ve alpha-1-antitrypsin +ve alpha-1-antichymotrypsin +ve Ki-67 +ve

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