Essentials in Bone and Soft-Tissue Pathology (eBook)

Preface 5
Contents 6
Contributors 7
Chapter 1 8
Bone Structure, Development and Bone Biology 8
The Skeleton 8
Bone Formation and Degradation 8
Bone Architecture 9
Gross Morphology 9
Parts of a Long Bone 9
Microscopic Features of Bone 11
Blood Supply of Bone 12
Nerve Supply of Bones 12
Bone Cells 13
Osteoprogenitor Cells 13
Osteoblasts 13
Osteocytes 13
Osteoclasts 14
Bone Matrix 15
Collagen 16
Enzymes 16
Alkaline Phosphatase 16
The Hydrated (Muco)Polysaccharide Gels 17
Factors Important in Mineralization 17
The Regulation of Bone and Cartilage 18
Parathyroid Hormone 18
Calcitonin 19
Vitamin D 19
Vitamin A 20
Estrogens 20
Androgens 20
Growth Hormone 20
Proteolipids 20
Growth Factors 21
Transforming Growth Factor-Beta 21
Bone Morphogenetic Proteins 21
Other Growth Factors 21
Mechanosensory Systems and Stretch Studies (Wolff’s Law) 22
Suggested Readings 22
Chapter 2 23
Common Problems in Orthopedic Pathology Including Trauma, Reactive Conditions and Necrosis of Bone 23
Healing of Bone 23
Fracture Union 24
Complications 25
Distraction Osteogenesis (Callotasis/Ilizarov Lengthening) 25
Heterotopic Ossification 26
Myositis Ossificans 26
Reflex Sympathetic Dystrophy (Sudeck Dystrophy or Algodystrophy) 27
Bizzare Parosteal Osteochondromatous Proliferation (BPOP or Nora Lesion) 28
Osteonecrosis 29
Suggested Readings 36
Chapter 3 37
Arthropathies 37
Common Features of Arthropathies 37
Radiological Aspects of Arthropathies 37
Alignment 38
Bones 38
Cartilage 38
Distribution 39
Extraordinary Findings 40
Soft-Tissues 40
Specific Arthritidies 40
The Productive Arthritidies 40
Osteoarthritis 40
Neuropathic Arthropathy (Charcot’s Joints) 42
Calcium Pyrophosphate Dihydrate Crystal Deposition Disease (CPPD) 44
Hemophilia 45
The Destructive (Inflammatory) Arthritidies 46
Rheumatoid Arthritis 46
Juvenile Rheumatoid Arthritis (Juvenile Chronic Arthritis) 49
Septic Arthritis 49
Gout 50
Psoriatic Arthritis 53
Reactive Arthritis 54
Ankylosing Spondylitis 54
Pigmented Villonodular Synovitis 55
Productive and Destructive Arthropathies 57
Nondestructive and Nonproductive Arthropathies 57
Miscellaneous Joint-Related Conditions 58
Osteochondritis Dissecans 58
Synovial Chondromatosis (Synovial Chondrometaplasia) 58
Chondromalacia Patella 58
Suggested Readings 60
Chapter 4 61
Infections of Bones 61
Suggested Reading 66
Chapter 5 67
Metabolic Bone Disorders 67
Suggested Readings 74
Chapter 6 75
Bone Cysts 75
Unicameral Bone Cyst 76
Aneurysmal Bone Cyst 78
Subchondral Cysts 81
Osteoarthritic Cysts 82
Intraosseous Ganglion 83
Cartilage Forming Tumors 84
Chondroblastoma 84
Chondromyxoid Fibroma 86
Osteochondroma 87
Chondroma 90
Chondrosarcoma 96
Conventional Chondrosarcoma 96
Chondrosarcoma Variants 98
Mesenchymal Chondrosarcoma 98
Clear Cell Chondrosarcoma 100
Dedifferentiated Chondrosarcoma 102
Secondary Chondrosarcoma 104
Bone Forming Lesions 105
Bone Island 105
Osteoma 107
Osteoid Osteoma 107
Osteoblastoma 110
Osteosarcoma 112
Conventional Osteosarcoma 112
Parosteal Osteosarcoma 114
Periosteal Osteosarcoma 116
Telangiectatic Osteosarcoma 118
Other Variants of Osteosarcoma 122
Fibrous and Fibrohistiocytic Tumors 124
Nonossifying Fibroma 124
Fibrous Dysplasia 126
Osteofibrous Dysplasia 130
Desmoplastic Fibroma 132
Fibrosarcoma of Bone 133
Malignant Fibrous Histiocytoma 135
Ewing Sarcoma 136
Giant Cell Lesions 140
Giant Cell Tumor 140
Giant Cell Reparative Granuloma 143
Adamantinoma 147
Notochordal Tumors 149
Chordoma 149
Benign Notochordal Cell Rest 152
Vascular Neoplasms 152
Hemangioma 153
Epithelioid Hemangioma 154
Angiomatosis 155
Massive Osteolysis 155
Hemophilic Pseudotumor 156
Epithelioid Hemangioendothelioma 156
Angiosarcoma of Bone 158
Hematopoietic Tumors 158
Plasma Cell Neoplasms (Plasma Cell Myeloma and Plasmacytoma) 160
Granulocytic Sarcoma 160
Non Hodgkin Lymphoma 161
Hodgkin Lymphoma 161
Langerhans Cell Histiocytosis 161
Erdheim Chester Disease 162
Other Hematopoietic Disorders 162
Suggested Readings 163
Chapter 7 164
Tumors and Tumor-Like Lesions of the Soft-Tissues 164
Soft-Tissue Tumors 164
Vascular Tumors 164
Capillary Hemangioma (Pyogenic Granuloma) 164
Cavernous Hemangioma 165
Histocytic (Epithelioid) Hemangioma (Angiolymphoid Hyperplasia with Eosinophilia) 166
Intramuscular Hemangioma (Intramuscular Angiolipoma) 168
Venous Hemangioma 168
Angiomatosis 168
Arteriovenous Hemangioma (AV Malformation) 170
Papillary Endothelial Hyperplasia (Intravascular Vegetant Hemangioendothelioma of Masson) 170
Spindle Cell Hemangioma (Spindle Cell Hemangioendothelioma) 171
Lymphangioma 173
Kaposiform Hemangioendothelioma 173
Epithelioid Hemangioendothelioma (Intravascular Bronchioloalveolar Tumor) 174
Hobnail Hemangioendothelioma (Dabska Tumor, Papillary Intralymphatic Angioendothelioma) 175
Retiform Hemangioendothelioma 176
Kaposi Sarcoma 177
Angiosarcoma 178
Tumors of Adipose Tissue 179
Lipoma 179
Lipomatosis 180
Angiolipoma 181
Spindle Cell Lipoma/Pleomorphic Lipoma 182
Hibernoma 182
Liposarcoma 183
Well-Differentiated Liposarcomas/Atypical Lipomatous Tumor 184
Myxoid/Round Cell Liposarcoma 185
Pleomorphic Liposarcoma 187
De-differentiated Liposarcoma 187
Fibrous Tumors 188
Elastofibroma 188
Soft-Tissue Myxoma (Intramuscular Myxoma, Juxta-Articular Myxoma, Cutaneous Myxoma) 189
Nuchal Fibroma 190
Keloid 191
Fibroma of tendon sheath 191
Desmoplastic Fibroblastoma 191
Calcifying Aponeurotic Fibroma 192
Fibromatoses 192
Solitary Fibrous Tumor 194
Malignant Solitary Fibrous Tumor 195
Dermatofibrosarcoma Protuberans 196
Low Grade Myxofibrosarcoma (Myxoid Malignant Fibrous Histiocytoma) 196
Low Grade Fibromyxoid Sarcoma (Hyalinizing Spindle Cell Tumor with Giant Rosettes) 198
Adult Fibrosarcoma 198
Malignant Fibrohistiocytoma and Pleomorphic Undifferentiated Sarcoma 199
Myogenic Tumors 201
Leiomyoma (Soft-Tissue) 201
Rhabdomyoma (Non-cardiac) 201
Leiomyosarcoma 202
Rhabdomyosarcoma 203
Neural Tumors 206
Traumatic Neuroma 206
Schwannoma (Neurilemoma) 206
Neurofibroma 207
Granular Cell Tumor (Granular Cell Schwannoma, Granular Cell Myoblastoma) 208
Malignant Peripheral Nerve Sheath Tumor (MPNST, Malignant Schwannoma, Neurofibrosarcoma) 210
Tumors with Pericytic or Modified Perivascular Cell Differentiation 211
Glomus Tumor 211
Myopericytoma 212
Hemangiopericytoma 212
Tumors of Uncertain Histogenesis and Differentiation 213
Clear Cell Sarcoma of Soft-Tissue (Malignant Melanoma of Soft Part) 213
Angiomatoid Fibrous Histiocytoma 213
Ossifying Fibromyxoid Tumor 214
Synovial Sarcoma 215
Extraskeletal Myxoid Chondrosarcoma (Chordoid Sarcoma) 215
Alveolar Soft Part Sarcoma 217
Desmoplastic Small Round Cell Tumor 217
Epithelioid Sarcoma 219
Non-neoplastic Conditions Frequently Misdiagnosed as Sarcoma (Pseudosarcoma) 219
Nodular Fasciitis 219
Proliferative Fasciitis/Myositis 221
Suggested Readings 221
Index 222