Aneurysmal bone cyst |
10-15 |
Metaphysis of vertebrae, flat bones, humerus, tibia |
Usually, history of trauma, f/b increasing swelling with little pain. There may be pathological fracture or spinal pressure symptoms |
Well defined radiolucent, eccentric cyst |
Spongy hemorrhagic mass |
Fibrous tissue, vascular spaces |
Unicameral bone cyst |
10-20 |
Metaphysis of Humerus, femur |
Usually, asymptomatic |
Well demarcated, radiolucent cyst extending up to physeal plate |
Cystic mass |
Well vascularized fibrous tissue with hemosiderin and cholesterol clefts |
Fibrous dysplasia |
10-30 |
Metaphysis, diaphysis of Neck of femur, tibia, base of skull |
May be mono or polyostotic, Pathological fractures and progressive deformity |
Cystic areas in metaphysis, lucent patches typically have ground glass appearance |
Coarse gritty, Grayish yellow |
Loose cellular fibrous tissue with widespread patches of woven bone and scattered giant cells |
Chondromyxoid Fibroma |
10-25 |
Metaphysis of tibia, fibula, femur, feet, pelvis |
Asymptomatic, pathological fracture |
Eccentrically placed lytic lesion with well-defined sclerotic margins |
Solid yellowish white or tan |
Patches of myxomatous tissue with stellate cells, islands of hyaline cartilage, fibrous tissue |
Giant cell tumor |
20-40 |
Epiphysis and metaphysis of Femur, tibia, radius |
Pain with swelling, pathological fracture |
Eccentric, cystic lesion in mature bone, extending up to the subchondral plate, soap bubble appearance |
Reddish fleshy mass |
Multinucleated giant cells, stromal cells, cellular atypia with mitotic figures |
Eosinophilic granuloma |
05-10 |
Metaphysis of Flat bones, mandible, spine and long bones |
Local pain, swelling and tenderness |
Well demarcated oval radiolucent area, associated with marked reactive sclerosis |
Soft, granular or gelatinous mass |
Sheets of Langerhans cells |
Osteomyelitis |
Any age |
Metaphysis, diaphysis of femur, tibia, femur, and humerus |
Discharging sinus, fever, malaise, local pain and swelling |
Multiple aggressive lytic lesions, serpiginous lytic pattern is more Specific sequestrum and involucrum are often seen |
Bone destruction, cavities containing pus with sequestrum |
Inflammatory cells around areas of acellular bone or microscopic sequestrum, prominent periosteal bone proliferation |
Chondro-sarcoma |
30-60 |
Pelvis rib, vertebrae, and metaphysis of humerus, femur |
Dull ache or gradually enlarging lump |
Radiolucent area with central flecks of calcification |
Lobulated with gelatinous shiny areas |
Lobules of highly atypical cells, including binucleate cells |
Epithelial metastasis |
Any age |
Diffuse pattern of Vertebrae, pelvis, rib, femur, skull, humerus rare below elbow and knees) |
Pain |
Bone destruction, osteolytic; osteoblastic response with Ca prostate |
Osteolytic, rarely sclerotic |
Malignant cells with vascular invasion |
Hemangio-endothelioma |
20-30 |
Metaphysis, diaphysis, less commonly, epiphysis of femur, tibia, feet and calvarium |
Pain and swelling |
Expansive, osteolytic and poorly demarcated lesions. “soap bubble” matrix with a sclerotic margin |
Well-circumscribed, irregular borders soft, bright red hemorrhagic appearance |
Solid nests and anastomosing cords of round, polygonal, or spindle-shaped cells with eosinophilic cytoplasm. Intracytoplasmic vacuolization |
Angiosarcoma |
Any age |
Metaphyseal and diaphyseal of any bone, multifocal |
Pain and swelling |
Eccentric, lytic, metaphyseal and diaphyseal, well circumscribed areas of rarefaction |
Variable |
Anastomosing vascular channels lined by highly atypical endothelial cells |
Non ossifying fibromas |
10-20 |
Metaphysis of tibia, femur |
Pain |
Eccentric, sharply delimited lesion |
Solid, Granular, brown, dark red |
Fibrous tissue arranged in storiform pattern, foamy and hemosiderin laden macrophages |