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Musculoskeletal (including trauma and soft tissues)
Published in Dave Maudgil, Anthony Watkinson, The Essential Guide to the New FRCR Part 2A and Radiology Boards, 2017
Dave Maudgil, Anthony Watkinson
The differential diagnosis for bone sclerosis with a periosteal reaction includes the following conditions. True or false? Osteoid osteoma.Syphilis.Chondromyxoid fibroma.MFH.Lymphoma.
Distal Femoral Non-Epiphyseal Cortical Chondroblastoma Confirmed with H3F3B p. Lys36Met Mutation
Published in Fetal and Pediatric Pathology, 2023
Haiyan Gu, Lingling Sun, Jiufa Cui, Lan Yu, Jigang Wang
Pathologically, non-epiphyseal chondroblastoma is similar to its epiphyseal counterparts. Osteoblastoma and osteoid osteoma usually arise from metaphysis or diaphysis, but distinct bone-forming morphology can help make differential diagnoses. Although with cortical fracture, we excluded chondroblastoma-like osteosarcoma and clear cell chondrosarcoma because of the absence of extensive bone destruction, cytological atypia, and neoplastic osteoid matrix in the present case. Giant cell tumors may mimic chondroblastoma microscopically, but they tend to occur in the mature skeleton and show an H3F3A p.Gly34Trp mutation. The smaller, unevenly distributed osteoclast-like giant cells and mononuclear cells with nuclear grooves are the typical morphological features of chondroblastoma. Chondromyxoid fibroma also can occur in the metaphysis and shows a well-defined lytic and eccentric lesion, but it has a lobular growth pattern with pleomorphic stellate cells embedded in a myxoid matrix. Recent studies reported that p. Lys36Met mutations in H3F3B and less frequently in H3F3A were identified in more than 90% of chondroblastomas while seldom detected in other giant cell-rich bone tumors [13]. Lu et al. [14] further confirmed the immunoreactivity of H3.3 K36M antibody has high sensitivity and specificity for diagnosing chondroblastoma. In equivocal cases, p.Lys36Met mutation analysis and immunoreactivity of H3.3 K36M would be valuable.