Pathology

Locomotor system 1 - bonePathologyAchondroplasiaSee the short and disproportionately thick bones

Osteogenesis Imperfecta- See the very large numbers of rib fractures (arrows). The infant died very shortly after birth.

This shows severe Pagets disease ofbone from a 77 year old female.

Histology in a late stage of the disease.The trabeculae of the cancellous bone aremarkedly thickened. This picture is describedas a mosaic pattern, with haphazardly arrangedcement lines which link haphazardly arrangedunits of lamellar (cancellous) bone. Here, theosteoblastic and osteoclastic activity hassubsided. Arrows indicate the reversal lines.

An example of an acute fractureofthe femur in a child, with displacement,shortening and a large haematoma. Fracture ofa femur results in a great loss of blood andmay cause death if not treated quickly

This shows healing fractures oftibia and fibula. See the early resorption ofhaematomas and callus formation

This is an example of an osteoidesteoma of the finger. See the sclerotic centralnidus (arrow)

On histology, this is a low power viewfrom the centre of the osteoid osteoma. Thereare randomly interconnecting trabeculae ofwoven bone and these are predominantlyrimmed by osteoblasts (arrows). Thecytological features are entirely benign

This shows a cartilagecappedexostosis (arrow), also called anosteochondroma, which is arising from theupper humerus from a man aged 21

(AKA mushroomy thing)

This is an example ofenchondromatosis or Olliers disease in a boy,15 years old, with multiple enchondromas(arrows) present

This is a benign chondroblastoma(arrows) in the head of the humerus of a maleaged 16. He presented with pain in theshoulder and the tumour was curettedfollowing biopsy diagnosis. It recurred and thehead of the humerus was then excised

The giant cell tumour (arrows)occurred in the tibia in a man aged 29 years.He had noticed a slowly growing lump for 11months and there had been a dull ache in theregion made worse by walking. X-ray showeda large cystic radiolucent area in the uppertibia.

An osteosarcoma (arrows) of thefemur in a girl aged 11 years and this is anamputation specimen

Histology shows an osteosarcoma. Youcan see the haphazardly deposited pink osteoid(arrows) present surrounding and between themalignant tumour cells. The tumour cells varyconsiderably in size and shape and many havelarge hyperchromatic nuclei.

Osteosarcoma of the femur. Thehaemorrhagic hole is the site of a biopsy. Thelower part of the tumour is fibrous: the portion inthe shaft shows osteogenic activity. Male aged 31.

This was from a 69 year old withPagets disease of bone who had a history of 2months of a painful lump in the upper tibia

This is a chondrosarcoma of thescapula in a woman aged 35. She sufferedfrom multiple hereditary exostoses and a massarising from the shoulder blade had recentlyincreased in size and become painful. This isan operative surgical specimen. Note the whitetranslucent appearance of the tumour

Histology shows a chondrosarcoma.There is increased and uneven cellularity withmoderately pleomorphic cells present in achondroid matrix (blue arrows). A mitoticfigure is seen (red arrow).

This is another example of achondrosarcoma. Note the translucent whiteappearance, also seen in this tumour

Chordoma. This arose in the sacrumand is an operative surgical specimen

This is the spine and humerusshowing metastatic (black arrows) breastcarcinoma from a female aged 51 years. Thereis a pathological fracture (red arrows) of thehumeral neck and crush fractures of vertebrae

This shows multiple metastases tothe skull from a neuroblastoma of the adrenalgland from a one year old child

This is the spine from a womanaged 62 with multiple myeloma (arrows). Shehad presented with a 15 month history of bonepain. Radiological examination showedcollapse of several vertebrae and multipleradiolucent areas in the skull. Serum protein83g/l; Bence Jones protein found in her urine,Hb 8.5g/dl; 14% plasma cells in aspirated bonemarrow. Her blood urea rose to 51.3 mmol/l, 5days before her death

Bone tumoursBenignOsteogenic osteoid osteoma.;osteoblastomaChondrogenic: osteochondroma; chondroma,chondroblastoma, chondromyxoid fibromaUnknown origin giant cell tumourFibrogenic metaphyseal fibrous defectVarious mesenchymal tumours may also occur in bone such as haemangiomas, lipomas and neurilemmomas.

Malignant (Note: haematopoietic malignancies though present in bone marrow are not included in this grouping.)Osteogenic osteosarcomaChrondrogenic chondrosarcomaUnknown malignant germ cell tumour,Ewings tumourFibrogenic fibrosarcomaNotochord - chordoma.Various malignant mesenchymal tumours may also be seen in bonesCant remember the exact mnemonic. Pete wrote it downPlease Remember The Bony Lesions

ProstateRenalThyroidBreastLung