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100 BIOMEDICAL FACTOIDS
This page contains 100 factoids from the field of
biomedicine. There are about 180 additional pages in this
series.
This page has no value as a treatment guide or as a diagnostic
guide. It is merely a collection of interesting pieces of
information collected over the years. It has no connection with
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© 2007 Jules J. Berman
201
ONCOCYTES.
There are a number of cells with similar cytoplasmic morphology
that are characterized by large numbers of mitochondria
in the cytoplasm, producing a fine pink (sometimes amphophilic)
granularity on Papanicolaou stain, and an eosinophilic granularity
on H and E staining.
They are:
Oncocytes.
Hurthle cells (aka Ashkenazy cells) of the thyroid.
Apocrine cells.
Hepatocytes.
Proximal tubular epithelial cells of the kidney.
key words: biology , JB
202
PHAGOCYTOSIS.
A phagosome results when a particle is surrounded by cytoplasmic membrane,
which pinches off and becomes internalized (in the cell).
The phagosome merges with a primary (inactive) lysosome,
to produce a secondary lysosome.
key words: biology , JB
203
THE HISTORY OF DNA.
Up until the 1940's it was debated whether DNA hand any function
in the cell, other than a structural purpose.
key words: biology, JB
204
ROLE OF NITRIC OXIDE IN HYPERYTENSION OF CHRONIC RENAL DISEASE.
In chronic renal failure, there is an accumulation in the circulation
of methylated arginine analogs that can inhibit NO synthesis.
NO is an important regulator of vasodilation.
--------------------
Vallance P, Leone A, Calver A, Collier J, Moncada S. Accumulation of
an endogenous inhibitor of nitric oxide synthesis in chronic renal failure.
Lancet 339:572-575, 1992.
key words: biology, kidney, JB
205
NOR'S AND THE NUMBER OF NUCLEOLI.
Each NOR (=nucleolar organizer region) can form a nucleolus.
In G2-phase, there are 20 NOR's.
But you don't see 20 nucleoli, because the NOR-encoded nucleoli
always fuse to form one or two big nucleoli.
--------------------
Field DH, Fitzgerald PH, Sin YT. Nucleolar silver-stained patterns related
to cell cycle phase and cell generation of PHA-stimulated human lymphocytes.
Cytobios 41:23-33, 1984
key words: biology , nucleus, JB
206
NUCLEOLAR ORGANIZER REGION.
AgNOR counts may be useful to:
Grade lymphomas.
Distinguish benign from malignant melanocytic lesions.
Distinguish reactive mesothelial cells from mesotheliomas.
--------------------
Underwood JCE, Giri DD. Nucleolar organizer regions as diagnostic
discriminants of malignancy. J of Pathol 155:95-96, 1988.
key words: biology , nucleus, JB
207
NUCLEOLAR ORGANIZER REGION.
NOR's are the chromosomal segments that code for ribosomal RNA.
NOR's are found on chromosomes 13, 14, 15, 21, 22.
They show up in interphase nuclei by silver stain (AgNOR's).
Silver stain impregnates the acidic proteins at these chromosomal sites
(not DNA or rRNA).
--------------------
Underwood JCE, Giri DD. Nucleolar organizer regions as diagnostic
discriminants of malignancy. J of Pathol 155:95-96, 1988.
key words: biology , nucleus, JB
208
CELL.
Derived from the Latin `cella', a compartment.
key words: biology , terminology, JB
209
HeLa CELLS.
A cell line derived from a human cervical carcinoma that rapidly divides,
and is used as a `basic' human cell by biologists.
The patient who originally had this carcinoma was autopsied
at The Johns Hopkins Hospital, and was named: `He... La...'.
key words: biology , tissue culture, JB
210
WEIBEL-PALADE BODIES.
Disk shaped (thin) organelles with a vague fibrous composition,
found in the cytoplasm of endothelial cells of small vessels.
Seen also in some vascular tumors.
key words: biology , vascular, hemangioma, angiosarcoma, JB
211
DIFFERENTIAL HISTOLOGIC DIAGNOSIS OF MALAKOPLAKIA
renal cell carcinoma
fibroxanthosarcoma
malignant xanthogranuloma
retroperitoneal fibrosis.
--------------------
Bennington JL, Beckwith JB. Tumors of the Kidney, Renal Pelvis,
and Ureter AFIP, p 323, 1975
key words: bladder, genitourinary, microbiology, malacoplakia, JB
212
MALAKOPLAKIA.
Most often seen in:
Bladder.
Renal pelvis.
Ureter.
Rarely seen in:
Retroperitoneum.
Prostate.
Testis.
Epididymis.
Renal parenchyma.
--------------------
Bennington JL, Beckwith JB. Tumors of the Kidney, Renal Pelvis,
and Ureter AFIP, p 323, 1975
key words: bladder, microbiology, genitourinary, malacoplakia, JB
213
MALAKOPLAKIA
Often, malakoplakia of the renal
pelvis and ureter is clinically unnoticed
and found only at autopsy
--------------------
Bennington JL, Beckwith JB. Tumors of the Kidney, Renal Pelvis,
and Ureter AFIP, p 323, 1975
key words: bladder, microbiology, renal, genitourinary, malacoplakia, JB
214
FRESH FROZEN PLASMA
Fresh Frozen Plasma (FFP) is defined as the fluid portion of one unit of
human blood that has been centrifuged, separated, and frozen solid at
-18 degrees centigrade (or colder) within 6 hours of collection.
key words: blood, bank, transfusion, JB
215
USE OF FRESH FROZEN PLASMA
The use of FFP has increased tenfold within the past 10
years and reached almost 2 million units annually.
Unfortunately, there is little solid evidence to support the clinical
value of most of this increased usage.
key words: blood, bank, transfusion, JB
216
FRESH FROZEN PLASMA
FFP contains:
labile and stable components of coagulation
labile and stable components of fibrinolysis
labile and stable components of complement
the proteins that maintain oncotic pressure
the proteins that modulate immunity
various proteins that have diverse activities
key words: blood, bank, transfusion, JB
217
USING FRESH FROZEN PLASMA AS A VOLUME EXPANDER
There is apparently little justified use of FFP as volume expander or as
nutritional source
Better alternatives are available
key words: blood, bank, transfusion, JB
218
CIRCUMSTANCES WHERE FRESH FROZEN PLASMA MAY HAVE USE
Some coagulation deficiencies (component therapy is often better)
Some patients requiring massive transfusions
Some patients with multiple coagulation defects (e.g. liver failure)
With plasma exchange for thrombotic thrombocytopenic purpura (TTP)
Infants with protein-losing enteropathy
Some patients with other immune deficiencies.
key words: blood, bank, transfusion, JB
219
RISKS OF FRESH FROZEN PLASMA
alloimmunization
anaphylactoid reactions,
excess intravascular volume
viral (disease) transmission
key words: blood, bank, transfusion, JB
220
USE OF FRESH FROZEN PLASMA AS A VOLUME EXPANDER
Preferable to FFP as volume expanders are:
Crystalloid
colloid solutions
hydroxyethyl starch
dextran
key words: blood, bank, transfusion, JB
221
DEDIFFERENTIATED CHONDROSARCOMA.
This entity has been newly added to the WHO classification of bone tumors.
Histologically, look for highly anaplastic sarcomatous tissue,
adjacent to a borderline or low grade chondrosarcoma.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, cartilage, sarcoma, JB
222
CLEAR CELL CHONDROSARCOMA.
This entity has recently been added to the WHO classification of bone tumors.
It is a tumor of low grade malignancy.
Histologic features:
Rounded will with clear cytoplasm.
Small amounts of cartilaginous or chondroid matrix.
Sometimes giant cells, bone trabeculae are seen.
Sometimes aneurysmal bonecyst-like areas are seen.
Occurs most commonly in adults.
Most often occurs in proximal femur, humerus, and tibia.
This tumor is sometimes referred to as malignant chondroblastoma.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, cartilage, sarcoma, JB
223
IS THERE A MALIGNANT COUNTERPART OF CHONDROBLASTOMA.
The term malignant chondroblastoma has not been established.
Yet there are reports of morphologically unremarkable chondroblastomas
that have metastasized to lung.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, cartilage, sarcoma, tumor biology, JB
224
OSTEOFIBROUS DYSPLASIA.
This entity has been recently included in the WHO classification
of bone tumors and was formerly known as ossifying fibroma.
Occurs almost exclusively in the tibia or fibula of young children.
Ossifying fibroma and fibrous dysplasia both are characterized
by fibrous tissue containing trabeculae of immature nonlamellar bone.
The key difference between fibrous dysplasia and ossifying fibroma
is that, in ossifying fibroma, the surface of trabeculae are covered
by active osteoblasts.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, classification, JB
225
AGGRESSIVE OSTOBLASTOMA.
The new WHO classification offers a solution to the difficult diagnostic
problem of distinguishing an atypical osteoblastoma from an osteosarcoma.
(i.e., when there are numerous large osteoblasts with atypical nuclei,
along with numerous giant cells).
The new classification recognizes aggressive (malignant) osteoblastoma,
which has a biologic behavior intermediate between osteoblasoma
and osteosarcoma.
These tumors lack necrosis, atypical mitoses, and malignant chondrocytes,
characteristic of osteosarcoma.
No instances of metastases have been reported for aggressive osteoblastoma.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, classification, sarcoma, JB
226
NEW CLASSIFICATION OF BONE TUMORS.
The new classification divides osteosarcomas into central (medullary)
and peripheral (surface) types.
Central tumors include:
Classic osteosarcoma.
Telangiectatic osteosarcoma.
Well-differentiated (low grade) osteosarcoma.
Small cell or round cell osteosarcoma.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, classification, sarcoma, JB
227
TELANGIECTATIC OSTEOSARCOMA.
May easily be mistaken for:
Aneurysmal bone cyst.
Malignant giant cell tumor.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, osteogenic sarcoma, JB
228
WELL-DIFFERENTIATED OSTEOSARCOMA.
Histologically similar to:
Fibrous dysplasia.
Parosteal (juxtacortical) osteosarcoma.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, osteogenic sarcoma, JB
229
ROUND CELL OSTEOSARCOMA.
Looks similar to:
Ewing's sarcoma.
Other osteosarcomas.
Round cell osteosarcoma may respond differently to treatment
than other osteosarcomas and should be specifically diagnosed.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, osteogenic sarcoma, JB
230
SURFACE (PERIPHERAL) OSTEOSARCOMAS.
Includes:
Parosteal (juxtacortical) osteosarcoma.
Periosteal osteosarcoma.
High grade surface osteosarcoma.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, osteogenic sarcoma, JB
231
AMELOBLASTIC FIBROMA.
Often mistaken for ameloblastoma, but is clinically
and morphologically distinct.
Ameloblastic fibroma occurs in children (almost always < 21 years).
It is benign, and is treated by curettage.
Look for strands of epithelial cells entrapped in dense stroma
(little or none of the stellate reticulum seen in a true ameloblastoma).
--------------------
Chuong R, Kaban LB. Diagnosis and treatment of jaw tumors in children.
J Oral Maxillofac Surg 43:323-332, 1985.
key words: bone, bone tumor, pediatric, oral, ENT, JB
232
GIANT CELL TUMOR (OSTEOCLASTOMA).
The WHO does not distinguish benign from malignant giant cell tumors
because attempts at grading these tumors have not
reliably predicted behavior.
WHO considers all giant cell tumors to be potentially malignant.
Recurrence of giant cell tumors after curettage is 20% to 50%.
--------------------
Schajowicz F, Sissons HA, Sobin LH. The World Health Organization's
histologic classification of bone tumors: a commentary on the second edition.
Cancer 75:1208-1214, 1995.
key words: bone, bone tumor, tumor biology, sarcoma, JB
233
NON-NEOPLASTIC LESIONS OF BONE THAT MIMIC NEOPLASMS.
Aneurysmal bone cyst.
Cortical irregularity syndrome.
Solitary bone cyst.
Subchondral cyst.
Intraosseous ganglion.
Florid reactive periostitis.
Bizarre parosteal osteochondromatous proliferation.
Subungual exostosis.
Hemophilic pseudotumor.
Condensing osteitis.
Amyloid tumor of bone.
--------------------
Fechner RE, Mills SE. Atlas of Tumor Pathology, Third Series, Fascicle 8,
Tumors of the Bones and Joints.
Armed Forces Institute of Pathology, Washington, D.C., p 38, 1993
key words: bone, classification, benign, JB
234
INHERITED SKELETAL DISORDERS.
A variety of skeletal disorders, many of which cause the sutures
of the skull plates to fuse prematurely.
1/3000 babies has one of about 100 different inherited syndromes
that produce premature fusion of skull bones.
--------------------
Angier N. Family of errant genes is found to be related to variety
of skeletal ills. The New York Times, C1, Tuesday, Nov 1, 1994.
key words: bone, congenital, epidemiology, incidence, JB
235
MASTOCYTOSIS INVOLVING BONE.
It would be very unusual for a patient to have mastocytosis involving
bone without first having mastocytosis involving skin.
About 15% of patients with mastocytosis will have bone involvement
(as determined by radiologic changes).
--------------------
Spjut HJ, Ayala AG. Neoplams and tumorlike lesions of bone. In:
Silverberg SG, ed., Principles and Practice of Surgical Pathology Wiley,
New York, p. 428, 1983.
key words: bone, dermatology, hematology, skin, JB
236
RELAPSING POLYCHONDRITIS.
Recurring painful inflammation of cartilage.
Seen most often in:
Ear.
Nose.
Costochondral junctions.
Joints.
Respiratory tract cartilaginous rings.
An autoimmune mechanism has been proposed as the etiology of this disease.
--------------------
Rosai J. Ackerman's Surgical Pathology. C.V. Mosby, St. Louis,
p. 1851, 1989.
key words: bone, dermatology, skin, joint, rheumatology, JB
237
LESIONS WITH SIMILAR RADIOLOGIC FINDINGS (UNILOCULAR HYPODENSITY).
Adenoameloblastoma.
Dentigerous cyst.
Odontogenic keratocyst.
Radicular cyst.
key words: bone, diagnosis, radiology, JB
238
CODMAN'S TRIANGLE.
In expansile bone tumors, the periosteum is lifted
from the cortex of the bone.
The angle between the cortex and the lifted periosteum
is seen as a triangle on x-ray.
key words: bone, diagnosis, radiology, JB
239
LESIONS WITH SIMILAR RADIOLOGIC FINDINGS (MULTILOCULAR HYPODENSITIES).
Ameloblastoma.
Aneurysmal bone cyst.
Central giant cell granuloma.
Odontogenic keratocyst.
Odontogenic myxoma.
key words: bone, diagnosis, radiology, JB
240
INVOLUCRUM.
Sheath, usually applied to the covering of a sequestrum of necrosed bone.
key words: bone, infection, osteomyelitis, JB
241
SOME SKELETAL DYSPLASIAS THAT PRODUCE SHORT LIMBS.
Achondroplasia.
Acrodysplasia with retinitis pigmentosa and nephropathy.
Acromesomelic dysplasia.
Asphyxiating thoracic dysplasia.
Campomelic dysplasia.
Chondrodysplasia punctata.
Chondroectodermal dysplasia.
Diastrophic dysplasia.
Dyschondrosteosis.
Hypochondroplasia.
Mesomelic dysplasias.
Metaphyseal chondrodysplasias.
Multiple epiphyseal dysplasia.
Pseudoachondroplasia.
Trichorhinophalangeal syndrome.
key words: bone, inherited, dwarf, dwarfism, skull, osteogenesis, JB
242
CALLUS.
A callus is bone repair at the site of a fracture.
The cytologic picture of a callus changes during the weeks following fracture.
In the first 2 weeks, look for atypical mononucleated cells,
giant cells, and fibroblasts in a myxoid stroma.
At about 6 weeks, you can see lamellar bone characterized by osteocytes,
chondroblasts, chondrocytes, and atypical mesenchymal cells.
--------------------
Hajdu SI. Soft Tissue and Bone. In. Bibbo M, ed., Comprehensive Cytology,
WB Saunders, Philadelphia, 1991, pp. 502-526.
key words: bone, JB
243
LACK OF MORPHOLOGIC DIVERSITY OF BONE LESIONS.
There are only a few ways that bone reacts to pathology,
the most common is with a profusion of giant cells and fibroblasts.
Subsequently, there are many bone lesions that look more or less identical
on histology or aspiration.
To make a specific diagnosis, the pathologist uses:
Radiologic information (the growth pattern of the lesion).
Anatomic information (the location of the tumor and the bone involved).
Clinical information (the age of the patient and presenting symptoms).
Morphologic information (size of lesion, rate of growth, etc.).
Any other advice the clinician or radiologist can provide.
key words: bone, JB
244
FNA OF BONE.
Most bone tumors and many non-neoplastic bone lesions
(the radiologically lytic or hypodense lesions) are soft,
and can be sampled by needle.
key words: bone, JB
245
CYTOLOGY OF PRIMARY BONE TUMORS.
The authors saw 4 cytologic patterns in 69 patients:
1. Small round or oval cells (Ewing's sarcoma).
2. Oval, round or spindle-shaped cells (fibrosarcoma, synovial sarcoma).
3. Polymorphic cells with giant cells (giant cell tumor of bone
and osteosarcoma).
4. Epithelial cells (ameloblastoma).
In 9 cases of osteosarcoma, there were highly atypical bizarre cells,
often containing a large hyperchromatic macronucleus and granular cytoplasm.
Giant cells were generally smaller than those found in giant cell tumors.
--------------------
Agarwal PK, Wahal KM. Cytopathologic study of primary tumors of bones
and joints. Acta Cytol 27:23-27, 1983.
key words: bone, JB
246
BRODIE'S ABSCESS.
A sequestered pocket of inflammation (usually pus) within a bone,
usually caused by Staphylococcus and involving the metaphysis.
key words: bone, JB
247
OSTEOMA.
Uncommon tumor.
Seen mostly in the frontal sinus and other paranasal sinuses.
Histologically consists of very dense cortical bone.
--------------------
Spjut HJ, Ayala AG. Neoplasms and tumorlike lesions of bone.
In: Silverberg SG, ed., Principles and Practice of Surgical Pathology,
Wiley, New York, pp405-443, 1983.
key words: bone, JB
248
OSTEOPETROSIS.
Also known as Albers-Schonberg disease or Marble bones.
A group of diseases with the common feature of increased bone density
but with a wide spectrum of clinical outcomes.
key words: bone, JB
249
MASSIVE OSTEOLYSIS.
Also known as disappearing bone disease and as Gorham's disease.
Affects patients under the age of 30.
Characterized as widely destructive lytic lesions of more than one bone.
On histology, look for angiomatous change of the bone.
--------------------
Spjut HJ, Ayala AG. Neoplams and tumorlike lesions of bone.
In: Silverberg SG, ed., Principles and Practice of Surgical Pathology,
Wiley, New York, p. 429, 1983
key words: bone, JB
250
TUMOR DESTRUCTION OF BONE: A MISNOMER.
Tumors almost never directly destroy bone.
Rather, stimulated host osteoclasts remove bone in response to the pressure
of enlarging masses in the bone.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation
of imaging studies and pathologic findings.
Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, JB
251
GARRE'S SCLEROSING OSTEOMYELITIS.
Reactive ossification in a bone,
due to a smoldering infection (osteomyelitis).
key words: bone, JB
252
OSTEOMA
Not the same as osteoid osteoma.
An osteoma is a mass of dense bone occurring almost exclusively in:
Skull.
Paranasal sinuses.
Facial bones.
It can occur at almost any age but usually in the 4th to 5th decades.
--------------------
Fechner RE, Mills SE. Atlas of Tumor Pathology, Third Series, Fascicle 8,
Tumors of the Bones and Joints. Armed Forces Institute of Pathology,
Washington, DC, p. 26, 1993
key words: bone, JB
253
PROGNOSIS OF POSTRADIATION SARCOMAS.
About the same prognosis as spontaneous (sporadic) counterparts.
--------------------
Fechner RE, Mills SE. Atlas of Tumor Pathology, Third Series, Fascicle 8,
Tumors of the Bones and Joints. Armed Forces Institute of Pathology,
Washington, D.C., p 26, 1993.
key words: bone, JB
254
PRIMARY LYMPHOMA OF BONE.
Uncommon, accounting for less than 4% of primary bone tumors.
Occurs after the second decade (i.e. not a childhood tumor).
Pain is a common complaint.
Almost always non-Hodgkins lymphoma.
--------------------
Spjut HJ, Ayala AG. Neoplams and tumorlike lesions of bone.
In: Silverberg SG, ed., Principles and Practice of Surgical Pathology, Wiley,
New York, p. 426, 1983.
key words: bone, lymphoma, JB
255
OSTEOPOROSIS
Affects 5 to 10 million Americans
Most common in women over 50
key words: bone, metabolic, aging, geriatrics, epidemiology, statistics, JB
256
IS PAGET'S DISEASE CAUSED BY AN INFECTIOUS DOG VIRUS?
An association has been suggested between Paget's disease and dog ownership.
This paper demonstrates canine distemper virus (CDV) RNA in 41% of patients
with Paget's disease (osteoclasts, oteoblasts and osteocytes).
CDV RNA was not found in control subjects.
--------------------
Gordon MT, Anderson DC, Sharpe PT. Canine distemper virus localised
in bone cells of patients with Paget's disease. Bone 12:195-201, 1991.
key words: bone, metabolic, microbiology, etiology, JB
257
DISSECTING OSTEITIS.
Dissecting osteitis is the destruction of cancellous bone due
to hyperparathyroidism and renal osteodystrophy.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, metabolism, endocrine, parathyroid, JB
258
LEAD KETTLE
Mnemonic for the tumors that most frequently metastasize to bone.
Remembering the the symbol for lead is Pb:
P = prostate.
B = breast.
K = kidney.
T = thyroid.
L = lung.
key words: bone, metastasis, tumor biology, JB
259
BACTERIAL OSTEOMYELITIS.
The majority of cases of bacterial osteomyelitis is caused by Staphylococci.
--------------------
Waldvogel FA, Vasey H. Osteomyelitis: the past decade. New Engl J Med
300:360-370, 1980.
key words: bone, microbiology, JB
260
ODONTOGENIC KERATOCYST.
According to the author, an odontogenic keratocyst is any cyst
with a thin lining of squamous epithelium located in the jaw bones.
Since these cysts can arise from a variety of presumed biologic mechanisms,
some of which confer names suggestive of these mechanisms,
the author suggests signing out odontogenic keratocysts as:
`odontogenic keratocyst: primordial, residual, dentigerous,
or lateral periodontal type.'
These cysts often recur, presumably because their thin squamous lining
permits outpouching of the cyst and the formation of daughter cysts.
--------------------
Greer RO Jr. The oral cavity. In: Silverberg SG, ed. Principles
and Practice of Surgical Pathology, Wiley, New York, 1983, pp. 653-695.
key words: bone, oral, JB
261
PERTHES DISEASE.
Avascular necrosis of the epiphysis of the femoral head.
Occurs in childhood.
Sometimes bilateral.
Occurs 4 times more frequently in boys than girls.
key words: bone, orthopedic, bone, pediatric, JB
262
ANKYLOSIS.
Immobilization of a joint.
key words: bone, orthopedics, JB
263
SUDECK'S ATROPHY.
A rapidly developing focal osteoporosis that sometimes follows a fracture.
Can be painful.
key words: bone, orthopedics, JB
264
OSTEOCHONDRITIS DISSECANS.
Focal ischemic necrosis of the epiphysis.
Only a peripheral segment of the epiphysis is involved.
The dead fragment of bone may loosen and fall into the joint space.
key words: bone, orthopedics, JB
265
CLASSIFICATION OF OSTEOSARCOMA BY SITE-OF-ORIGIN.
Medullary (=bone marrow).
Periosteal.
Parosteal.
Extra-skeletal.
key words: bone, osteogenic, sarcoma, terminology, JB
266
PODIATRIC TERMS.
Hallux valgus: angulation of the great toe toward the other toes.
Hallux varus: angulation of the great toe away from the other toes.
Bunion - abnormal prominence (exostosis) of the inner aspect
of the first metatarsal head, accompanied by bursal formation
and hallux valgus.
Hammer toe - the proximal phalanx of a toe (usually the second toe)
is extended and the second and distal phalanges are flexed,
producing a claw appearance of the toe.
key words: bone, podiatry, foot, toe, JB
267
HALLUX VALGUS.
Angulation of the great toe towards the other toes.
Usually results from a bunion (exostosis, bony overgrowth)
of the metatarsal head that displaces the great toe.
Hallux varus is an angulation of the great toe away from the other toes.
key words: bone, podiatry, JB
268
PROGNOSTIC INFLUENCE OF OSTEOSARCOMA CLASSIFICATION.
Although some claim that histologic subclassification of osteosarcoma
is useful, only intramedullary well-differentiated, fibrosarcomatous
osteosarcoma and parosteal osteosarcoma have improved prognoses.
key words: bone, prognosis, JB
269
CYSTIC LESIONS OF BONE: A MISNOMER.
Bone lesions are seldom cystic (i.e. composed of a fluid filled space).
Circumscribed radiolucent areas are almost always tissue-filled.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation
of imaging studies and pathologic findings.
Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
270
WELL-DEFINED DESTRUCTIVE LESION OF BONE SURROUNDED BY SCLEROSIS.
These lesions usually represent slow-growing lucent lesion, usually benign.
Examples of benign neoplasms with this radiologic feature include:
Unicameral bone cyst.
Subarticular osteoarthritic cyst.
Enchondroma.
Fibroxanthoma (nonossifying fibroma).
Chondromyxoid fibroma.
Chondroblastoma.
Fibrous dysplasia.
Liposclerosing myxofibrous tumor.
Angioma.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation
of imaging studies and pathologic findings.
Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
271
WELL-DEFINED DESTRUCTIVE LESION OF BONE SURROUNDED BY SCLEROSIS.
These lesions usually represent slow-growing lesions.
Their radiologic finding is a circumscribed lucency (area of bone destruction)
with a smooth margin surrounded by bony sclerosis.
Though these lesions are usually benign, exceptions that are
malignant neoplasms with this radiologic feature include:
Low grade chondrosarcoma.
Angiosarcoma.
Indolent metastatic carcinoma.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation
of imaging studies and pathologic findings.
Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
272
WELL-DEFINED DESTRUCTIVE LESIONS OF BONE SURROUNDED BY SCLEROSIS.
Sometimes a lucent lesion of bone surrounded by sclerosis shows
a fading sclerotic margin, blending into the surrounding bone.
Examples include:
Brodie's abscess.
Eosinophilic granuloma.
Osteoid osteoma.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
273
PUNCHED OUT DESTRUCTIVE BONE LESIONS (NO SURROUNDING SCLEROSIS).
Characterized radiologically by a geographic (well-circumscribed lesion
with a smooth border) lucency (area of bone destruction).
Examples include:
Giant cell tumor of bone.
Fast growing enchondromas.
Chondroblastomas.
Chondromyxoid fibromas.
Occasionally fibrous dysplasia.
Occasional malignancies such as myeloma and metastatic sarcomas.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
274
WELL-DEFINED DESTRUCTIVE BONE LESIONS AND IRREGULAR BORDER.
Characterized radiologically by a lucency (area of bone destruction)
with an irregular border.
Examples include:
Osteomyelitis.
Fibrosarcoma.
Osteosarcoma.
Rapidly-growing chondromyxoid fibromas.
Active enchondromas.
Chondrosarcomas.
Giant cell tumors.
Chordoma.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
275
MOTH-EATEN DESTRUCTIVE BONE LESION (CANCELLOUS OR CORTICAL BONE).
Examples are:
Metastatic carcinoma.
Lymphoma.
Osteosarcoma.
Chondrosarcoma.
Primary round cell sarcoma.
Osteomyelitis.
Acute disuse atrophy.
Sympthetic reflex osteodystropy.
Radiation effect.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
276
MOTH-EATEN DESTRUCTIVE BONE LESIONS IN CORTICAL AND CANCELLOUS BONE.
These lesions that destroy all areas of bone are often
the most aggressive tumors.
They include:
Primary round cell sarcomas of bone.
Lymphomas.
Aggressive fibrosarcomas of bone.
Matrix-producing sarcomas of bone.
Can also be seen in non-neoplastic lesions including hyperparathyroidism,
infection, reflex sympathetic ostodystrophy, stress reaction and fracture.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
277
MASTOCYTOSIS INVOLVING BONE.
About 15% of patients with mastocytosis have radiologic bone changes
(multiple) consistent with mastocytosis.
Histologically, these lesions must be distinguished from
lymphoma or histiocytosis.
A history of skin lesions helps, as does the Giemsa stain
for metachromatic granules.
--------------------
Spjut HJ, Ayala AG. Neoplasms and tumorlike lesions of bone. In:
Silverberg SG, ed., Principles and Practice of Surgical Pathology, Wiley,
New York, pp. 405-443, 1983.
key words: bone, radiology, JB
278
RADIOLOGIC FEATURES OF CANCELLOUS VERSUS CORTICAL BONE DESTRUCTION.
Cancellous bone has much more surface area than cortical bone and
is destroyed much more than cortical bone by enlarging tumors.
However, 30% - 50% of cancellous bone must be lost before it becomes
obvious on a bone film, while even small foci of cortical destruction
are conspicuous on x-ray.
--------------------
Ragsdale BD. Morphologic analysis of skeletal lesions: correlation of
imaging studies and pathologic findings. Adv Pathol Lab Med 6:445-490, 1993.
key words: bone, radiology, JB
279
OSTEOSARCOMA.
Osteosarcoma accounts for approximately 5% of the tumors in childhood.
In children, 80% of the tumors arise from the bones around the knee.
--------------------
Carter JR, Abdul-Karim FW: Pathology of childhood osteosarcoma.
Perspectives in Pediatric Pathology 9:133-170, 1987.
key words: bone, sarcoma, incidence, JB
280
CONVENTIONAL MEDULLARY OSTEOSARCOMA.
Histologically characterized by:
Mixed population of fibroblastic cells, collagen, cartilage,
osteoblasts,and osteoid.
Most of these components are cytologically malignant,
and show considerable nuclear pleomorphism and mitotic activity.
key words: bone, sarcoma, JB
281
MORGAGNI'S SYNDROME.
Hyperostosis frontalis interna.
plus:
Virilism and obesity.
key words: bone, skeleton, metabolic, inherited, JB
282
INTRAOSSEOUS LIPOMA.
According to authors, this tumor represents a little
over 2% of primary bone tumors.
On x-ray, intraosseous lipoma appears as a discrete osteolytic lesion,
often surrounded by sclerosis.
This tumor may present with pain.
Histologically, the tumor may contain areas of necrosis, calcification,
and fat necrosis (lipophages).
--------------------
Chow LT, Lee K. Intraosseous lipoma: a clinicopathologic study of nine cases.
Am J Surg Pathol 16:401-410, 1992.
key words: bone, soft tissue, JB
283
SCHMORL'S NODULE (SCHMORL'S NODE).
A vertical herniation of nucleosus pulposus (of intervertebral disk)
into the adjoining vertebral body.
key words: bone, spine, vertebrae, JB
284
ISSUES RELATED TO OBTAINING HEALTH DATA STATISTICS
Health Data in the Information Age: Use, disclosure and Privacy
272 pages, $39.95
National Academy Press
2101 Constitution Avenue, NW
Lockbox 285
Washington, D.C. 20055
phone 1-800-624-6242
key words: book, science, administration, epidemiology, JB
285
STRIATUM.
In the brain, the striatum is the caudate plus the putamen.
It is important in slow movements that require constant adjustments.
key words: brain, anatomy, cns, JB
286
CNS GERM CELL TUMORS.
Relative frequency of occurrence:
Germinoma .................... 40%.
Mixed ........................ 30%.
Teratoma ..................... 20%.
Yolk sac tumor
or embryonal carcinoma
or choriocarcinoma ......... 10%.
--------------------
Horowitz MB, Hall WA. Central nervous system germinomas: a review.
Arch Neurol 48:652-657, 1991.
key words: brain, brain tumor, incidence, JB
287
SURVIVAL AFTER CNS GERMINOMA.
The 5 year (median followup) survival of germinoma is 66% to 86%.
--------------------
Horowitz MB, Hall WA. Central nervous system germinomas: a review.
Arch Neurol 48:652-657, 1991.
key words: brain, brain tumor, prognosis, JB
288
MORPHOLOGIC VARIANTS OF MENINGIOMA.
Meningotheliomatous (also called syncytial meningioma).
Transitional.
Fibrous.
Angioblastic (the AFIP authors consider this a true hemangiopericytoma).
Psammomatous.
Secretory.
Microcystic.
Lymphoplasmacytic.
Chordoid.
Metaplastic.
Papillary.
Clear cell, pseudoglandular, sclerotic, rhabdoid, paraganglioma-like.
--------------------
Burger PC, Scheithauer BW. Atlas of Tumor Pathology (Third Series,
Fascicle 10) Tumors of the Central Nervous System. Armed Forces Institute
of Pathology, Washington, D.C., p. 269, 1994.
key words: brain, classification, JB
289
VON RECKLINGHAUSEN'S DISEASE IS NEUROFIBROMATOSIS TYPE 1.
Six or more cafe-au-lait macules (at least 5 mm diameter
in prepubescent patients and at least 15 mm in postpubescent patients).
Two or more neurofibromas of any type or one plexiform neurofibroma.
Freckles in axillary or inguinal regions.
An osseous lesion of sphenoid dysplasia or thinning of long-bone cortex,
with or without pseudoarthrosis.
Optic glioma.
Two or more Lisch nodules (iris hamartomas).
A parent, sibling, or child with the disease.
key words: brain, classification, terminology, familial, hereditary, JB
290
NEUROFIBROMATOSIS TYPE 2.
Neurofibromatosis type 2 may be diagnosed when one of the following
is present:
Bilateral 8th nerve masses.
or:
A parent, sibling, or child with neurofibroma; and either unilateral 8th
nerve mass or any one of the following:
Neurofibroma.
Meningioma.
Glioma.
Schwannoma.
Posterior capsular cataract or opacity at a young age.
key words: brain, classification, terminology, familial, hereditary, JB
291
PATHOLOGIC LESIONS SEEN IN ALZHEIMER'S DISEASE.
Neurofibrillary tangles.
Senile plaques.
Hirano bodies.
Granulovacuolar degeneration.
Congophilic angiopathy.
key words: brain, cns, aging, JB
292
CNS CHANGES COMMONLY SEEN IN AGING.
Thickened leptomeninges.
Decreased weight (10-20%).
Enlarged ventricles.
Neuronal loss.
Neurofibrillary tangles.
Senile plaques.
Granulovacuolar degeneration.
Lipofuscin.
Corpora amylacea (brain sand).
Hirano bodies.
key words: brain, cns, aging, JB
293
BRAIN TUMORS IN CHILDREN.
Approximately 50% of brain tumors in children are infratentorial.
Three-fourths of these are located in the cerebellum or 4th ventricle.
key words: brain, cns, childhood, pediatric, neurology, incidence, JB
294
SITES OF ORIGIN OF TERATOMAS.
Base of skull.
Intracranial.
Intrapericardial.
Mediastinum (anterior).
Nasopharynx.
Neck (usually in thyroid gland).
Ovary.
Pineal gland.
Presacral.
Retroperitoneal.
Testis.
key words: brain, cns, childhood, pediatrics, JB
295
BENIGN CYSTIC LESIONS OF THE BRAIN.
Colloid cyst of the 3rd ventricle.
Rathke cleft cyst.
Endodermal cyst.
Ependymal (glioependymal cyst).
Choroid plexus cyst.
Epidermoid and dermoid cysts.
Arachnoid cysts.
Pineal cyst.
Nerve root cyst.
Synovial cyst of spine.
--------------------
Burger PC, Scheithauer BW. Atlas of Tumor Pathology (Third Series,
Fascicle 10) Tumors of the Central Nervous System. Armed Forces Institute
of Pathology, Washington, D.C., p. 355, 1994.
key words: brain, cns, classfication, JB
296
ATHETOID MOVEMENTS.
Slow and writhing.
Movements resemble a worm or a snake.
Movements disappear with sleep.
The athetoid hand is produced by flexing some fingers,
while extending other fingers.
key words: brain, cns, clinical, JB
297
CLINICAL SIGNS OF MENINGEAL IRRITATION.
Nuchal rigidity.
Brudzinski's sign.
Kernig's sign.
key words: brain, CNS, CSF, JB
298
ONION BULB NEUROPATHY.
Peripheral nerves wrapped by several Schwann cells,
with abundant intervening collagen.
Results from repeated episodes of demyelinization and remyelinization.
Seen in:
Degerine-Sottas disease.
Charcot-Marie-Tooth.
Refsum's disease.
key words: brain, CNS, demyelination, JB
299
INCIDENCE OF INTRACRANIAL GLIOMAS (ALL AGES).
Glioblastoma .................... 55%.
Astrocytomas .................... 21%.
Ependymomas ..................... 6%.
Medulloblastomas ................ 6%.
Oligodendrogliomas .............. 5%.
Choroid plexus papillomas ....... 2%.
--------------------
Rubinstein LJ. Tumors of the nervous system. Armed Forces Institute
of Pathology, Washington, D.C. p. 2, 1972.
key words: brain, CNS, epidemiology, JB
300
INCIDENCE OF CEREBELLAR AND FOURTH VENTRICLE TUMORS.
Astrocytomas .................... 29%.
Medulloblastomas ................ 25%.
Ependymomas ..................... 11%.
Hemangioblastomas ............... 12%.
Meningiomas ..................... 5%.
Choroid plexus papillomas ....... 2%.
Metastatic neoplasms ............ 3%.
--------------------
Rubinstein LJ. Tumors of the nervous system. Armed Forces Institute
of Pathology, Washington, D.C. p. 2, 1972.
key words: brain, CNS, epidemiology, JB
Last modified: December 5, 2006