Journal of Pathology and Translational Medicine

Case Study

Primary leiomyosarcoma of the bone: a case report: Ala Abu-Dayeh, Samir Alhyassat; J Pathol Transl Med. 2024;58(1):35-39. Published online January 10, 2024; DOI: https://doi.org/10.4132/jptm.2023.11.14

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Primary leiomyosarcoma of the bone is rare. Histologically, it resembles leiomyosarcoma of soft tissue. Given the rarity of this entity, its diagnosis should be made only after clinical studies and workup have excluded metastasis from other sites. Herein, we describe an additional case of primary bone leiomyosarcoma. We report a 32-year-old female patient, who presented with right knee pain and was found to have a right distal femur mass by imaging studies. Biopsy showed a neoplasm composed of fascicles of spindle cells, arranged in different patterns, with significant pleomorphism. The tumor cells were positive for smooth muscle actin, focally positive for desmin and H-caldesmon. No other masses in the body were detected by imaging studies. The diagnosis of leiomyosarcoma of the bone was rendered. Given the broad diagnostic differential of primary bone leiomyosarcoma, it is important to be aware of this rare bone tumor phenotype and of its histomorphologic and immunohistochemical features for an accurate diagnosis.

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Primary Leiomyosarcoma of Bone: A Rare Case Series with Review of Literature
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Review

Aneurysmal bone cyst: a review: Elham Nasri, John David Reith; J Pathol Transl Med. 2023;57(2):81-87. Published online March 14, 2023; DOI: https://doi.org/10.4132/jptm.2023.02.23

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Abstract PDF

Aneurysmal bone cyst (ABC) is a benign locally destructive bone neoplasm composed of multi-loculated blood-filled cystic spaces. The most common sites of involvement are the meta-diaphysis of the long bones and posterior elements of the vertebrae. Secondary, ABC-like changes can complicate a variety of other benign and malignant primary bone neoplasms, including giant cell tumor, fibrous dysplasia, and osteosarcoma. About two-third of primary ABCs have a rearrangement of the USP6 gene, which is not present in the ABC-like changes that occur secondary to other primary bone tumors (i.e., secondary ABC). Primary ABC of bone carries a variable but generally high rate of local recurrence. This paper provides an overview of the pathophysiology, clinical presentation, radiographic and pathologic findings, treatment, and prognosis of ABC.

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Case Studies

Juxtacortical chondromyxoid fibroma in the small bones: two cases with unusual location and a literature review: Sun-Ju Oh, So Hak Chung; J Pathol Transl Med. 2022;56(3):157-160. Published online January 21, 2022; DOI: https://doi.org/10.4132/jptm.2021.12.15

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Abstract PDF

Chondromyxoid fibroma is a rare bone tumor of cartilaginous origin, representing less than 1% of all bone tumors. It preferentially arises in the eccentric location of the metaphysis of a long tubular bone. Juxtacortical locations are reported infrequently in the long bones and even more rarely in short tubular bones, with only three cases documented. Here we present two new cases of juxtacortical chondromyxoid fibroma in the small bones. One was an intracortical osteolytic lesion of the metatarsal bone of the foot with degenerative atypia that histologically should be differentiated from chondrosarcoma. The other was a phalangeal mass protruding into the interphalangeal joint of the hand, which had been labeled mistakenly as a soft tissue mass preoperatively. These cases illustrated that chondromyxoid fibromas have various the manifestations and should be included in the differential diagnosis of an osteolytic lesion or an exophytic mass in the small bones.

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Cartilage Forming Tumors of the Skeleton
Julio A. Diaz-Perez, Andrew E. Rosenberg
Advances in Anatomic Pathology.2025; 32(2): 132. CrossRef

Intraoperative frozen cytology of intraosseous cystic meningioma in the sphenoid bone: Na Rae Kim, Gie-Taek Yie; J Pathol Transl Med. 2020;54(6):508-512. Published online July 1, 2020; DOI: https://doi.org/10.4132/jptm.2020.05.21

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Abstract PDF

Meningiomas in bone are rarely subjected to fine-needle aspiration diagnosis, and those arising in the skull bone with a cystic presentation are rare. A 24-year-old woman presented with subdural hemorrhage, and subsequent radiology depicted an osteolytic mass-like lesion in the sphenoid bone. Intraoperatively, a solid and cystic hemorrhagic lesion mimicking an aneurysmal bone cyst was observed in the sphenoid bone with dural tearing. Frozen cytology showed singly scattered or epithelioid clusters of round to elongated cells intermixed with many neutrophils. Tumor cells had bland-looking round nuclei with rare prominent nucleoli and nuclear inclusions and eosinophilic granular to globoid cytoplasm in capillary-rich fragments. Histology revealed intraosseous meningothelial and microcystic meningioma (World Health Organization grade 1) in right lesser wing of the sphenoid bone. Considering its unusual location and cytologic findings, differential diagnoses included chordoma, chondroma, chondrosarcoma, and aneurysmal bone cyst. The present case posed a diagnostic challenge due to possible confusion with these entities.

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Purely cystic intraosseous meningioma of the skull: A radiologic conundrum and histologic challenge
Diego Rojas, Arman Kavoussi, Ashley Rose Ricciardelli, Alex Flores, Sricharan Gopakumar, Luis Carrete, Hsiang-Chih Lu, Alex W. Brenner, Akash J. Patel
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Abdullah Almajnooni, Matthew Vega, Lin Cheng, Paolo Gattuso, Mary K. Allen‐Proctor
Diagnostic Cytopathology.2023;[Epub] CrossRef
Exploring the role of epidermal growth factor receptor variant III in meningeal tumors
Rashmi Rana, Vaishnavi Rathi, Kirti Chauhan, Kriti Jain, Satnam Singh Chhabra, Rajesh Acharya, Samir Kumar Kalra, Anshul Gupta, Sunila Jain, Nirmal Kumar Ganguly, Dharmendra Kumar Yadav, Timir Tripathi
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Hepatocellular Carcinoma Arising in a Huge Hepatocellular Adenoma with Bone Marrow Metaplasia: Hyo Jeong Kang, Hui Jeong Jeong, So-Woon Kim, Eunsil Yu, Young-Joo Lee, So Yeon Kim, Jihun Kim; J Pathol Transl Med. 2018;52(4):226-231. Published online December 27, 2017; DOI: https://doi.org/10.4132/jptm.2017.11.12

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Abstract PDF

Hepatocellular adenoma (HCA) is the most common type of benign liver tumor, and its major complication is malignant transformation to hepatocellular carcinoma (HCC). Here, we report a case of HCC arising in HCA with bone marrow metaplasia in a 24-year-old Korean woman who presented with abdominal discomfort. A huge liver mass was found on abdominal ultrasonography. She underwent surgical hepatic resection, and the resected specimen was entirely involved by a 20-cm-sized tumor. Histological review revealed a well differentiated HCC arising from inflammatory HCA with β-catenin nuclear positivity and bone marrow metaplasia that contained hematopoietic cells. This case was unique because malignant transformation, inflammatory type HCA, β-catenin nuclear staining, and bone marrow metaplasia were simultaneously observed. Additionally, it should be noted that a large HCA with β-catenin activation can undergo malignant transformation and should be surgically resected in a timely manner.

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Haythem Yacoub, Hela Kchir, Dhouha Cherif, Hajer Hassine, Slim Haouet, Asma Ayari, Habiba Mizouni, Saber Mannai, Mohamed Tahar Khalfallah, Nadia Maamouri
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Original Articles

Intraosseous Hibernoma: A Rare and Unique Intraosseous Lesion: Boram Song, Hye Jin Ryu, Cheol Lee, Kyung Chul Moon; J Pathol Transl Med. 2017;51(5):499-504. Published online August 22, 2017; DOI: https://doi.org/10.4132/jptm.2017.07.28

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Abstract PDF

Background
Hibernoma is a rare benign tumor of adults that is composed of multivacuolated adipocytes resembling brown fat cells. Hibernoma typically occurs in soft tissue, and intraosseous examples are very rare. Intraosseous hibernomas can radiologically mimic metastatic carcinoma and other tumorous conditions. Methods: To collect the intraosseous hibernomas, we searched the pathologic database and reviewed the hematoxylin and eosin (H&E)–stained slides of bone biopsy samples performed to differentiate radiologically abnormal bone lesions from 2006 to 2016. A total of six intraosseous hibernoma cases were collected, and clinical and radiological information was verified from electronic medical records. H&E slide review and immunohistochemical staining for CD68, pan-cytokeratin, and S-100 protein were performed. Results: Magnetic resonance imaging of intraosseous hibernomas showed low signal intensity with slightly hyperintense foci on T1 and intermediate to high signal intensity on T2 weighted images. Intraosseous hibernomas appeared as heterogeneous sclerotic lesions with trabecular thickening on computed tomography scans and revealed mild hypermetabolism on positron emission tomography scans. Histopathologically, the bone marrow space was replaced by sheets of multivacuolated, foamy adipocytes resembling brown fat cells, without destruction of bone trabeculae. In immunohistochemical analysis, the tumor cells were negative for CD68 and pan-cytokeratin and positive for S-100 protein. Conclusions: Intraosseous hibernoma is very rare. This tumor can be overlooked due to its rarity and resemblance to bone marrow fat. Pathologists need to be aware of this entity to avoid misdiagnosis of this rare lesion.

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Gökhan Tonkaz, Ertugrul Cakir, Mehmet Tonkaz, Demet Sengul
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Allen Ko, Colin C. Rowell, James B. Vogler, Dmitri E. Samoilov
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Co-expression of MDM2 and CDK4 in transformed human mesenchymal stem cells causes high-grade sarcoma with a dedifferentiated liposarcoma-like morphology
Yu Jin Kim, Mingi Kim, Hyung Kyu Park, Dan Bi Yu, Kyungsoo Jung, Kyoung Song, Yoon-La Choi
Laboratory Investigation.2019; 99(9): 1309. CrossRef
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Francisco A. Myslicki, Andrew E. Rosenberg, Ivan Chaitowitz, Ty K. Subhawong
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Proposal of an Appropriate Decalcification Method of Bone Marrow Biopsy Specimens in the Era of Expanding Genetic Molecular Study: Sung-Eun Choi, Soon Won Hong, Sun Och Yoon; J Pathol Transl Med. 2015;49(3):236-242. Published online May 15, 2015; DOI: https://doi.org/10.4132/jptm.2015.03.16

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Abstract PDF

Background
The conventional method for decalcification of bone specimens uses hydrochloric acid (HCl) and is notorious for damaging cellular RNA, DNA, and proteins, thus complicating molecular and immunohistochemical analyses. A method that can effectively decalcify while preserving genetic material is necessary. Methods: Pairs of bilateral bone marrow biopsies sampled from 53 patients were decalcified according to protocols of two comparison groups: EDTA versus HCl and RDO GOLD (RDO) versus HCl. Pairs of right and left bone marrow biopsy samples harvested from 28 cases were allocated into the EDTA versus HCl comparison group, and 25 cases to the RDO versus HCl comparison group. The decalcification protocols were compared with regards to histomorphology, immunohistochemistry, and molecular analysis. For molecular analysis, we randomly selected 5 cases from the EDTA versus HCl and RDO versus HCl groups. Results: The decalcification time for appropriate histomorphologic analysis was the longest in the EDTA method and the shortest in the RDO method. EDTA was superior to RDO or HCl in DNA yield and integrity, assessed via DNA extraction, polymerase chain reaction, and silver in situ hybridization using DNA probes. The EDTA method maintained intact nuclear protein staining on immunohistochemistry, while the HCl method produced poor quality images. Staining after the RDO method had equivocal results. RNA in situ hybridization using kappa and lambda RNA probes measured RNA integrity; the EDTA and RDO method had the best quality, followed by HCl. Conclusions: The EDTA protocol would be the best in preserving genetic material. RDO may be an acceptable alternative when rapid decalcification is necessary.

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Review

Role of Osteal Macrophages in Bone Metabolism: Sun Wook Cho; J Pathol Transl Med. 2015;49(2):102-104. Published online March 12, 2015; DOI: https://doi.org/10.4132/jptm.2015.02.02

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Abstract PDF

Macrophages have been shown to have pleiotropic functions in various pathophysiologies, especially in terms of anti-inflammatory and regenerative activity. Recently, the novel functions of bone marrow resident macrophages (called osteal macrophages) were intensively studied in bone development, remodeling and tissue repair processes. This review discusses the current evidence for a role of osteal macrophages in bone modeling, remodeling, and fracture healing processes.

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Brief Case Report

Periductal Stromal Tumor of Breast: A Case Report and A Review of Literature: Salma L. Abbasi, Kate McNamara, Mohammed S. Absar, Alison Darlington, Francene Clucas, Sami Titi; Korean J Pathol. 2014;48(6):442-444. Published online December 31, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.6.442

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Original Articles

Morphologic Alteration of Metastatic Neuroblastic Tumor in Bone Marrow after Chemotherapy: Go Eun Bae, Yeon-Lim Suh, Ki Woong Sung, Jung-Sun Kim; Korean J Pathol. 2013;47(5):433-442. Published online October 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.5.433

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Abstract PDF

Background

The aim of this study is to evaluate the histologic features of metastatic neuroblastic tumors (NTs) in bone marrow (BM) before and after chemotherapy in comparison with those of primary NTs.

Methods

A total of 294 biopsies from 48 children diagnosed with NTs with BM metastasis were examined. There were 48 primary neoplasm biopsies, 48 BM biopsies before chemotherapy, 36 primary neoplasm excisional biopsies after chemotherapy, and 162 BM biopsies after chemotherapy.

Results

Metastatic NTs in BM before chemotherapy were composed of undifferentiated and/or differentiating neuroblasts, but had neither ganglion cells nor Schwannian stroma. Metastatic foci of BM after chemotherapy were found to have differentiated into ganglion cells or Schwannian stroma, which became more prominent after further cycles of chemotherapy. Persistence of NTs or tumor cell types in BM after treatment did not show statistically significant correlation to patients' outcome. However, three out of five patients who newly developed poorly differentiated neuroblasts in BM after treatment expired due to disease progression.

Conclusions

Metastatic NTs in BM initially consist of undifferentiated or differentiating neuroblasts regardless of the primary tumor subtype, and become differentiated after chemotherapy. Newly appearing poorly differentiated neuroblasts after treatment might be an indicator for poor prognosis.

Citations

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Postchemotherapy gross residual tumor in non‐high‐risk neuroblastoma: Clinical significance and the role of adjuvant therapy
Eun Seop Seo, Hana Lim, Hee Won Cho, Hee Young Ju, Ji Won Lee, Keon Hee Yoo, Sanghoon Lee, Do Hoon Lim, Ki Woong Sung, Hong Hoe Koo
Pediatric Blood & Cancer.2022;[Epub] CrossRef

Biologic Response to Carbonated Hydroxyapatite Associated with Orthopedic Device: Experimental Study in a Rabbit Model: Samira Jebahi, Mongi Saoudi, Riadh Badraoui, Tarek Rebai, Hassane Oudadesse, Zoubaier Ellouz, Hassib Keskese, Abdelfattah El Feki, Hafed El Feki; Korean J Pathol. 2012;46(1):48-54. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.48

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Abstract PDF

Background

Carbonated hydroxyapatite (CHA) and related calcium phosphates have been studied for many years as implant materials due to their similarity with the mineral phase of bone. The main limitation of CHA ceramics as well as other bioactive materials is that they have poor mechanical proprieties. It is thought that the mechanical device can cause an increase in metabolic activity and bone healing. In this study we investigated the reactivity and tissue behaviour of implanted CHA biomaterial reinforced by mini external fixator.

Methods

The evaluation of biomaterial biocompatibility and osteogenesis was performed on a rabbit model over a period of 6 weeks by radiological, histological and scanning electron microscopy (SEM) coupled with energy dispersive X-ray SEM-energy-dispersive X-ray (EDX) analysis.

Results

While rabbits treated with CHA exhibited more bone formation, and fibrous tissue was observed when empty bone defects were observed. EDX analysis detected little calcium and phosphorus on the surface of the bone that was not implanted, while high content of calcium (62.7%) and phosphorus (38%) was found on the interface bone cement.

Conclusions

Bone repairing showed that the mini external fixator stimulated the ossification which was pushed when grafted by CHA. This effect may play an important role in the prevention of implant loosening.

Citations

Citations to this article as recorded by

A review: In vivo studies of bioceramics as bone substitute materials
Ali A. Al‐allaq, Jenan S. Kashan
Nano Select.2023; 4(2): 123. CrossRef
Improvement in bioactivity and corrosion resistance of Ti by hydroxyapatite deposition using ultrasonic mechanical coating and armoring
Ming-Hong Lin, Yi-Cheng Chen, Chun-Chung Liao, Liang-Wei Lin, Chin-Fu Chen, Kuang-Kuo Wang, Shyi-Tien Chen, Yi-Huang Hsueh, Chien-Hui Wu, Shih-Fu Ou
Ceramics International.2022; 48(4): 4999. CrossRef
Novel bioactive collagen-polyurethane-pectin scaffolds for potential application in bone regenerative medicine
Myriam L. Guzmán-Chávez, Jesús A. Claudio-Rizo, Martín Caldera-Villalobos, Denis A. Cabrera-Munguía, Juan J. Becerra-Rodríguez, Nayeli Rodríguez-Fuentes
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Chitosan-Based Gastric Dressing Materials Loaded with Pomegranate Peel as Bioactive Agents: Pharmacokinetics and Effects on Experimentally Induced Gastric Ulcers in Rabbits
Samira Jebahi, Ghada Ben Salah, Soufien Jarray, Mounir Naffati, Mohammad Ayaz Ahmad, Faten Brahmi, Mohd Saeed, Arif J. Siddiqui, Khabir Abdelmajid, Riadh Badraoui
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Is THP‐1 viability affected by the crystallinity of nanostructured carbonated hydroxyapatites?
Renata Moraes Lira, Suelen Cristina Sartoretto, Carolina da Silva Gouveia Pedrosa, Mônica Diuana Calasans‐Maia, Paulo Emílio Leite, José Mauro Granjeiro
Journal of Biomedical Materials Research Part A.2021; 109(7): 1266. CrossRef
Does the incorporation of zinc into calcium phosphate improve bone repair? A systematic review
Rebecca Cruz, José Calasans-Maia, Suelen Sartoretto, Vittório Moraschini, Alexandre Malta Rossi, Rafael Seabra Louro, José Mauro Granjeiro, Monica Diuana Calasans-Maia
Ceramics International.2018; 44(2): 1240. CrossRef
Adsorption of nucleotides on biomimetic apatite: The case of adenosine 5′ monophosphate (AMP)
K. Hammami, H. El Feki, O. Marsan, C. Drouet
Applied Surface Science.2015; 353: 165. CrossRef
Finite element analysis and cellular studies on advanced, controlled porous structures with subsurface continuity in bio-implantable titanium alloys
P. Lambert, S. Ankem, Z. Wyatt, K. M. Ferlin, J. Fisher
Journal of Biomedical Materials Research Part A.2014; 102(1): 225. CrossRef
The impact of orthopedic device associated with carbonated hydroxyapatite on the oxidative balance: experimental study of bone healing rabbit model
Samira Jebahi, Riadh Nsiri, Mohammed Boujbiha, Ezedine Bouroga, Tarek Rebai, Hassib Keskes, Abdelfattah El Feki, Hassane Oudadesse, Hafed El Feki
European Journal of Orthopaedic Surgery & Traumatology.2013; 23(7): 759. CrossRef

Case Reports

Chondromyxoid Fibroma of the Ethmoid Sinus Complicated by a Brain Abscess: A Case Report and Literature Review.: Kyu Yeoun Won, Juhie Lee, Youn Wha Kim, Eui Jong Kim, Sung Wan Kim, Yong Koo Park; Korean J Pathol. 2010;44(5):547-550.; DOI: https://doi.org/10.4132/KoreanJPathol.2010.44.5.547

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Abstract PDF

Chondromyxoid fibroma (CMF) is a relatively rare bone tumor that was first described by Jaffe and Lichtenstein in 1948. CMF of the sinonasal tract is very rare. A 28-year-old male presented with long-standing, intermittent, pulsatile pain in the right temporal area. A computed tomography scan showed a 20 x 19 mm round, bony density in the right ethmoid sinus with fluid collection in the ethmoid and frontal sinuses. Additionally, a cystic lesion with surrounding edema was found in the right frontal lobe. The patient underwent a partial ethmoidectomy and frontostomy. A histological examination showed polygonal and stellate cells in a myxoid and chondroid background with a pattern of lobulation and plaque-like calcification. The bone lesion was revealed as a CMF of the ethmoidal sinus, and the frontal lobe cystic lesion was a brain abscess associated with the CMF. We present the case of a CMF of the ethmoid sinus complicated by a brain abscess.

Citations

Citations to this article as recorded by

Juxtacortical chondromyxoid fibroma in the small bones: two cases with unusual location and a literature review
Sun-Ju Oh, So Hak Chung
Journal of Pathology and Translational Medicine.2022; 56(3): 157. CrossRef
Treatment of cryotherapy and orthotopic transplantation following chondromyxoid fibroma of zygomatic bone
Zhi-Chao Zhu, Yi-Fei Yang, Xu Yang, Yan Liu, Yi-nan Cheng, Zhao-Yao Sun, Tian-Shu Xu, Wen-Jun Yang
Medicine.2018; 97(31): e11707. CrossRef

Intraosseous Neurilemmoma of the Mandible: A Case Report.: Kyu Yun Jang, Woo Sung Moon, Ho Sung Park; Korean J Pathol. 2009;43(1):88-91.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.1.88

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Abstract PDF

Neurilemmoma (Schwannoma) is a benign nerve sheath tumor that's composed entirely of well-differentiated Schwann cells. Intraosseous neurilemmomas are rare and they represent less than 1% of all benign primary bone tumors. We report here on an additional case of intraosseous neurilemmoma that was located in the mandible of a 77-year-old woman. CT revealed an expansile, well-defined lesion on the right side of the mandibular body with thinning of the cortex. The lesion was surgically removed and it was found to be a 2x1.7 cm-sized, bright yellowish, hard mass with hemorrhage and cyst formation. Histologically, the mass was a moderately cellular neoplasm and it showed distinct nuclear palisading, numerous Verocay bodies and tumor cells that were positively immunohistostained for S-100 protein. Two months after the operation, the patient has remained in a good condition with no signs or symptoms of tumor recurrence.

Citations

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Intraosseous benign peripheral nerve sheath tumor of the jaws: report of 4 new cases and a comprehensive literature review
Brendo Vinícius Rodrigues Louredo, Paulo Victor Mendes Penafort, Ana Luiza Oliveira Corrêa Roza, Maria Cecília Querido De Oliveira, Ricardo Pelletti Ocaña, Alexandre Machado Torres, Samuel de Barros Ferreira Júnior, André Caroli Rocha, Rafael Cabral da Co
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2025; 139(4): e104. CrossRef
Mandibular Schwannoma: A Systematic Review of 33 Case Reports
Ahmad Al Malak, Yasmina El Masri, Jad El Masri, Farah Sarmout, Mohammad Hassoun, Georges Aoun
Oral Diseases.2025;[Epub] CrossRef
Imaging Features of Intraosseous Schwannoma: A Case Series and Review of the Literature
Firoozeh Shomal Zadeh, Arash Azhideh, Jose G. Mantilla, Vijaya Kosaraju, Nitin Venugopal, Cree M. Gaskin, Atefe Pooyan, Ehsan Alipour, Majid Chalian
Diagnostics.2023; 13(9): 1610. CrossRef
Gnathic Schwannomas: A Report of Two Cases and Systematic Review of the Literature
Alberto Jose Peraza Labrador, Luciano Hermios Matos Valdez, Nestor Ricardo Gonzalez Marin, Karem Annelise Rodriguez Ibazetta, Marcelo Villacis, Joan Lopez Chacon, Hebert Ochoa Huaman, Harold Cuzcano Pariahuamán, Hosting Barría Angulo, Victoria Woo
Head and Neck Pathology.2023; 17(4): 984. CrossRef
Intraosseous schwannoma of the humerus: a rarity yet warrants consideration
Jagannath Kamath, Harshit Bhaskar Shetty, Arkesh Madegowda, Anusha S Bhatt
BMJ Case Reports.2021; 14(9): e240007. CrossRef
Intraosseous Schwannoma of the Jaws: An Updated Review of the Literature and Report of 2 New Cases Affecting the Mandible
Dru Perkins, Tudor I. Stiharu, James Q. Swift, Tran Volong Dao, Gisele N. Mainville
Journal of Oral and Maxillofacial Surgery.2018; 76(6): 1226. CrossRef

Clear Cell Chondrosarcoma Arising in Hyoid Bone.: Hae Jin Jeong, Sug Kyoung Ko, Myeng Sun Park, Hee Kyung Chang, Man Ha Huh; Korean J Pathol. 1997;31(5):470-475.

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Abstract PDF: Clear cell chondrosarcoma, first described by Unni in 1976, is distinguished from classical chondrosarcoma by a typical histological picture, mostly an epiphyseal site of origin, and relatively a benign clinical course. We present a case of clear cell chondrosarcoma arising from hyoid bone in a 70-year-old male. Histologically, large areas of closely packed cells with characteristic clear cytoplasm were seen in addition to the usual elements of a conventional chondrosarcoma. Our search and review of the literature did not reveal any reported case of clear cell chondrosarcoma arising from hyoid bone.

Intraosseous Lipoma A report of four cases.: Hye Jeong Choi, Mi Jin Gu, Joon Hyuk Choi, Duk Seop Shin, Kil Ho Cho; Korean J Pathol. 1999;33(6):467-470.

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Abstract PDF: Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.

Original Articles

Factors Influencing Regeneration of Calvarial Defects in Rats.: Sung Chul Lim, Young Sook Kim; Korean J Pathol. 1999;33(11):999-1008.

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Abstract PDF: An experimental study was done to evaluate factors influencing guided regeneration of bone in standardized calvarial bony defect. An 8 mm circular transosseous calvarial bony defect was made. Various material such as demineralized freeze-dried bone (DFDB), BioMesh , Millipore filter and its combination was placed in the bony defect. A sequential histopathologic, histochemical, immunohistochemical, and histomorphometric studies were done on the guided bone regeneration in the calvarial bony defect. Bone formation was sigificantly enhanced when the DFDB was retained within the bony defect with a protective bioabsorbable membrane. Inframembranous DFDB-filling was required to prevent collapse of the membrane and preserve spaces for bone regeneration. The bioabsorbable membrane should presumably remain intact for longer than at least 5 weeks to facilitate bone regeneration. The new bone formation was dependent on the barrier-effect (preserving secluded spaces) and inflammation-inducing property of membrane, and guiding bone regeneration of the grafts. Macrophages recruited by grafts were partly involved in decrease of bone regeneration via the sequential events of release of fibronectin, chemotactic effect of the fibronectin to fibroblasts, and collagen lay-down.

Cytologic Diagnosis of Metastatic Hepatocellular Carcinoma by Aspiration Cytology of Sacrum.: Jungweon Shim, Illhyang Ko; J Pathol Transl Med. 1990;1(2):179-184.

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Abstract PDF: Bone metastasis of hepatocellular carcinoma appears to be peculiar when clinical manifestation of liver disease is not apparent, and initial diagnosis of metastatic hepatocellular carcinoma by fine needle aspiration cytology is rarely obtained. We experienced a case of 45-year-old man with metastatic hepatocellular carcinoma in the sacrum, which was diagnosed by fine needle aspiration cytology. The intrahepatic mass, measuring 1.2 cm in diameter and kept unchanged in size for two years, was never proved to be hepatocellular carcinoma histopathologically. The aspirated neoplastic cells were mostly in sheets, showing abundant acidophilic cytoplasm and large, round. centrally located nuclei with single, prominent acidophilic mucleoti. In the cell block section, diagnosis of metastatic well-differentiated hepatocellular carcinoma was made without difficulty, and definite trabecular fashion with sinusoidal endothelial cell lining was found.

Case Reports

Cytologic Findings of Polyomavirus Infection in the Urine: A Case Report.: Mi Seon Kwon, Young Shin Kim, Kyo Young Lee, Yeong Jin Choi, Chang Suk Kang, Sang In Shim; J Pathol Transl Med. 1996;7(2):192-196.

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Abstract PDF: The principal significance of the urothelial changes caused by polyomavirus activation is in an erroneous diagnosis of urothelial cancer; however, the clue to their benign nature is the smooth structureless nuclear configuration and the relative paucity of affected cells. Though virologic studies and electron microscopy are usually needed to firmly establish the diagnosis, cytology is the most readily available and rapid means of establishing a presumptive diagnosis of human polyomavirus infection. A urine specimen of a 24-year-old man with hemorrhagic cystitis beginning two months after bone marrow transplantation for acute myeloblastic leukemia(M2) was submitted for cytologic evaluation. Cytologic findings revealed a few inclusion-bearing epithelial cells intermingled with erythrocytes, neutrophils, lymphocytes, and macrophages. Most of the inclusion-bearing -cells had large, round to ovoid nuclei almost completely filed with homogeneous dark, basophilic inclusion. The chromatin was clumped along the periphery and the cytoplasm was mostly degenerated. The other cells exhibited irregular inclusions attached to the nuclear membrane surrounded by an indistinct halo. These findings were consistent with polyomavirus infection.

Fine Needle Aspiration Cytology of Angiosarcoma of the Rib: A Case Report.: Hee Jung Kim, Mee Yon Cho, Soon Hee Jung, Kwang Gil Lee; J Pathol Transl Med. 1996;7(2):207-212.

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Abstract PDF: Angiosarcoma of the bone is rare with an incidence of 0.13%. It may be solitary or multiple. Its cytologic findings by FNA have rarely been reported. We report a case of angiosarcoma of the rib in a 66 year-old man. FNA revealed single or clusters of round to oval shaped cells in a hemorrhagic and myxoid background. The large central nuclei had irregular nuclear membrane, chromatin clumping and prominent nucleoli. The cytoplasm was scanty with an eosinophilic distinct cytoplasmic border. Erythrophagocytosis by malignant cells was also found. Histopathologic examination confirmed the diagnosis of angiosarcoma revealing irregular and com- plex anastomosing vascular channels lined by malignant round tumor cells, protruding into the lumen. Immunohistochemical staining revealed diffuse strong positive reaction to factor VIII-related antigen and CD31.

Original Article

The Usefulness of Fine Needle Aspiration Cytology of Bone Lesions.: Bohng Hee Kim, Gyung Yub Gong; J Pathol Transl Med. 2002;13(2):51-59.

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Abstract PDF: To determine the usefulness of fine needle aspiration cytology(FNAC) of bone lesions and the complementary role of FNAC and percutaneous needle biopsy, 75 cases of FNAC taken from bone lesions were analyzed. Correlations with histopathology were possible in 47 cases, including 14 cases of simultaneous core biopsy and 33 cases of subsequent open biopsy due to inadequate aspirates. Among 75 cases, 4 cases were benign tumors and tumor-like lesion, 11 cases were malignant primary bone tumors, 17 cases were metastatic tumors, and 43 cases were nonneoplastic bone lesions. The aspirates were adequate in 35 cases(46.7%), in all of which the discrimination between benignancy and malignancy was possible. The main reason for inadequate aspirates was due to hypocellularity. In the cases of aspiration and core biopsy simultaneously done, the diagnostic accuracy of aspiration, core biopsy, and both were 57%(8/14), 78.6%(11/14), and 92.9%(13/14), respectively. We conclude that a final diagnosis based on cytology is possible with the adequate aspirates and the clinical and radiological findings. Also we confirm the complementary role between FNAC and core biopsy in bone lesions.

Case Reports

Nasal Chondromesenchymal Hamartoma: A Case Report.: Jun Kang, Young Ok Hong, Geung Hwan Ahn, Young Min Kim, Hee Jeong Cha, Hye Jeong Choi; Korean J Pathol. 2007;41(4):258-262.

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Abstract PDF: We report a case of nasal chondromesenchymal hamartoma. A 14-year-old boy presented with a 5 cm sized mass in the left maxillary sinus, facial swelling and a loose tooth. A subtotal left maxillectomy with a bone graft was performed. The excised mass was composed of partly encapsulated, solid and cystic fragments of soft tissues. The mass contained chondroid and myxoid areas consisting of mesenchymal tissues including hyaline cartilage, osteoid and spindle cells in various proportions. The hyaline cartilage component was the most prominent. The spindle cell component had a fibrous matrix with variable myxoid or sclerotic changes. Thick hyalinized eosinophilic osteoid-like trabeculae were focally present. Immunohistochemically, all the mesenchymal cells tested positive for vimentin. The chondrocytes tested positive for the S-100 protein, and the spindle cell component showed focal immunoreactivity for smooth muscle actin and desmin. However, the cells were negative to pan-cytokeratin and p63.

Parosteal Ossifying Lipoma of Femur: A Case Report.: Jae Seok Lee, Wan Hyung Cho, Ji Yoong Yu, Min Suk Kim, Jae Soo Koh; Korean J Pathol. 2007;41(2):123-126.

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Abstract PDF: Parosteal lipoma is a rare and generally asymptomatic benign tumor of mature adipose tissue that is located in direct apposition to the external surface of the bone. These tumors are occasionally associated with reactive changes in the underlying bone. The reactive bone formation is generally restricted to the base of the tumor, that is, near the periosteum. We recently experienced a case of parosteal lipoma in the proximal femur, which displayed exuberant bone and cartilage formation, and this led us to a misdiagnosis of chondroblastic osteosarcoma on the initial biopsy. We report here on this case with a special emphasis on making the differential diagnosis from osteosarcoma.

Original Article

Expression of VEGF, MMP-9 and Neovascularization in Relationship to the Clinical Behavior of Giant Cell Tumors of Bone.: Kyung Hwa Lee, Jo Heon Kim, Min Keun Shim, Chang Woo Han, Sung Sun Kim, Sang Woo Juhng, Sung Taek Jung, Jae Hyuk Lee; Korean J Pathol. 2006;40(6):420-426.

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Abstract PDF: BACKGROUND
Giant cell tumors (GCT(s)) of bone are benign but can be locally aggressive neoplasms. Their clinical behavior has been difficult to predict on the basis of histology alone. This study investigated the neovascularization and expression of vascular endothelial growth factor (VEGF) as well as matrix metalloproteinase-9 (MMP-9) in GCT(s) of bone; in addition we evaluated their relationship to clinical behavior.
METHODS
We evaluated the microvessel number and density in 33 samples of giant cell tumor using CD34 immunohistochemistry. In addition, we examined the immunohistochemical expression of VEGF and MMP-9.
RESULTS
The microvessel number alone, not the microvessel density, had statistical association with the clinical stage of GCT(s) (p=0.045). The proportion of cases with strong expression of VEGF increased with advancing clinical stage, however, these results were not statistically significant (p=0.257). The percentage of the cases with strong expression of MMP-9 also increased with advancing clinical stage and this was statistically significant (p=0.022).
CONCLUSIONS
These results suggest that intratumor microvessel count and the expression of MMP-9 correlate with GCT stage. Evaluation of their expression may therefore provide prognostic information on the aggressive behavior of GCT(s) of bone.

Case Report

Endolymphatic Sac Tumor: A Case Report.: Dae Woon Eom, Jae Y Ro, Shin Kwang Khang, Chang Jin Kim, Kyung Ja Cho; Korean J Pathol. 2003;37(5):351-354.

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Abstract PDF: Endolymphatic sac tumor (ELST) is a very rare adenomatous tumor of the temporal bone histologically characterized by a typical papillary pattern. This tumor often shows a locally aggressive growth and recurrence despite its relatively benign histology. We report a case of endolymphatic sac tumor of the right jugular foramen in a 50 year-old male. Microscopically, the tumor was composed of uniform cuboidal to low columnar epithelial cells arranged in an arborizing papillary pattern. Under immunohistochemistry, the tumor cells were positive for cytokeratin, CD56, epithelial membrane antigen, neuron specific enolase, and vimentin.
Discussion
on the classification and histogenesis of adenomatous tumors of the middle ear and temporal bone has been active in western countries during the recent decades; however, these tumors have been very unusual in Korea. This is the second report of ELST in Korea, and consists of a discussion on related problems.

Original Article

An Effective Role Pulsed Unipolar Magnetic Field for Bony Decalcification.: Suk Keum Lee, Eun Young Chung, Gi Jin Kim, Dae Beom Song, Jo Ho Kim, Je G Chi; Korean J Pathol. 1993;27(2):125-133.

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Abstract PDF: To achieve optimal decalcification in tissue and tissue preservation, we have tried magnetic field method and made some promising results. We used pulsed unipolar magnetic field obtained by rectification of 250 V-60 cycle, A.C. As a new method of bony decalcification, using 5% nitric acid, 10% formic acid and 10% formic acid+3% hydrochloric acid solutions, experimental groups were decalcified in the center of the magnetic field. The concentration of calcium ion in the decalcifying solution was measured by calcium-oxalate turbidity test by photometry method, and direct visualization of calcium radiopacity was obtained by soft X-ray view during the decalcification process. The pH change during decalcification was continuously checked and needle penetration method was also used. All the decalcification solution used in this study showed accelerated effect of bony decalcification in the strong magnetic field. Among them 5% nitric acid produced complete decalcification for the medium size bony specimen (less than 10x10x10 mm) within 24 hours, and the histologic feature was almost free of acid-chemical degeneration. The pH of all the decalcification solutions decreased in the strong magnetic field, maximum within 4~6 hours, and kept strong acidity throughout the decalcification procedure. After removal of the magnetic field the pH of all the decalcification solution returned to their original values after 24 hours. It was presumed that the cause of the accelerated decalcification in the magnetic field was due to combined effects of the rapid increase of acidity and the increased molecular resonance to stimulate the ionization of mineral elements.

Case Reports

Clear Cell Sarcoma of the Kidney: A case report.: Soon Ae Oak, Bang Hur, Man Ha Huh; Korean J Pathol. 1993;27(1):81-84.

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Abstract PDF: Clear Cell Sarcoma of the Kidney(CCSK) is a rare malignant childhood tumor which is distinguished from Wilms tumor by its pathologic features, clinical presentation and frequent occurrence of metastasis to bone. We report a case of CCSK from a 2 year-old girl in the right kidney, followed by metastasis to thoracic vertebrae and left temporal lobe. Histogenesis of this tumor is controversial, although some studies suggest primitive mesenchymal origin. This case was studied with the aids of immunohistochemistry and electron microscopy in an effort to verify the histogenesis of the tumor. Vimentin was reactive in tumor cell, but cytokeratin, GFAP, S-100 protein and desmin were not stained, which confirmed the previous reports by others. Ultrastructural observation of the tumor cells showed neither features of epithelial cell nor differentiated mesenchymal cells.

Intraosseous Well Differentiated Osteosarcoma: A case report.: Mee Hye Oh, So Young Park, Yeon Lim Suh, Shin Khang Kang; Korean J Pathol. 1992;26(6):627-631.

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Abstract PDF: Well differentiated osteosarcomas are variants of osteosarcoma composed mainly of fibrous and osseous tissue with minimal cystologic atypia. This tumor may be misinterpretated as a benign lesion if the radiologic and clinical features are not taken into account. We report a typical case of intraosseous well differentiated osteosarcoma occuring in the left distal femur of a 58-year-old woman. Radiologically, it appered as an ill-defined lesion with a mixture of sclerotic and osteolytic ares. But there was a lack of highly destructive appearance of conventional osteosarcoma. Grossly, the mass occupied a metaphysis of the distal femur with extension into the diaphysis and epiphysis. Multifocal cortical destruction and sclerosis were also associated. Histologically, the mass showed typical features of intraosseous well differentiated osteosarcoma. There were various patterns of osteoid deposits and bone formation mimicking those of fibrous dysplasia, nonossifying fibroma or parosteal osteosarcoma.

Original Article

Ki-1 Positive T-Cell Lymphoma of Bone in a Child.: Hye Seon Ahn, Gil Ro Han, Jin Hee Sohn, Jung Il Suh, Young Hyeh Ko; Korean J Pathol. 1989;23(4):470-475.

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Abstract PDF: Ki-1 monoclonal antibody is a well known marker for Reed-Sternberg cells in Hodgkin's disease, but also occasionally reacts with activated lymphoid cells of either benign or malignant nature. Recently, Ki-1 antibody positive Non-Hodgkin's lymphoma, usually of large cell and/or polymorphous type, has been reported in the lymph nodes, skin, soft tissue, and stomach, but not in the bone. We report a case of multifocal primary bone lymphoma in a seven-year old body involving the left shoulder and right frontal bone, which proved to be a large cell, polymorphous lymphoma, helper T-cell type expressing Ki-1 antigen.

Case Report

Intracranial Encephalocele: an autopsy case of anterior basal type.: Hyun Wook Kang, Je G Chi, Tae Dong Park, Hum Rae Park; Korean J Pathol. 1988;22(4):500-504.

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Abstract PDF: Encephalocele is a relatively rare congenital anomaly which is classified into occipital, parietal, anterior syncipital and anterior basal type regarding to the protrusion site through the bony defect of the skull. Anterior basal type of encephalocele is important in view of it's pathogenesis as well as diagnostic difficulty because of invisibility on external appearance. We have experienced a case which could be best fit to anterior basal encephalocele. This type of encephalocele is extremely rare. This report deals with a case of deadborn of 34 weeks of gestation with body weight of 2400gm and head circumference of 32 cm. There was no evidence of protrusion of brain on external examination. On autopsy the normal brain structure was compressed by abnormal mass of brain with normal consistency which was found in the petrous portion of the parietal area and covered partly by the dura. In this case, there were another associated anomalies, such as atrophy of the left optic nerve, hemihypoplasia of the left mandible, patent ductus arteriosus, bilateral hydrocele, and Meckel's diverticulum.

Original Article

Lectin Binding Activities in Ewing's Sarcoma of the Bone.: Chul Woo Kim, Hyo Min Kim, Eui Keun Ham; Korean J Pathol. 1987;21(4):267-273.

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Abstract PDF: The binding activities of 6 plant lectins were studied in a total of 6 cases of Ewing's sarcoma of the bone, using the avidin-biotin-peroxidase complex (ABC) method on paraffin embedded material. The lectins used in this study were Ricinus communis agglutinin I (RCA I), Concanavalin A (Con-A), Peanut agglutinin (PNA), Wheat germ agglutinin (WGA), Ulex europeus I (UEA I), and Soybean agglutinin (SBA). However, no specific lectin, which showed consistent binding activity in the majority of Ewing's sarcoma cells was identified, in 5 of 6 cases, intracytoplasmic RCA I binding cells were occasionally observed, at somewhat regular intervals, among the neoplastic cell nests. Con-A stains were also positive in 4 cases, but the numbers of Cona-A binding cell were fewer than that of positive cell with RCA I, With PNA, WGA, UEA I, and SBA virtually no tumor cells were stained. These findings suggest that all Con-A positive cells and a part of RCA I binding cells are probably stromal macrophage-histiocytes, which are incorperated in neoplastic cells. And remaining RCA I positive cells seem to be either a kind of differentiating neoplastic cells or supporting cells having close correlation with the neoplastic cells.

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