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Structure of Normal Bone
Functions :
Supporting the body
Providing attachment site formuscles & tendons
provide motion
Protects vital organs &
houses of bone-marrows Mineral deposits, esp.
calcium
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Type of Bones
The flat bones
Skull, scapula, clavicle, vertebra, jaw & pelvis
The tubular bones
Femur, tibia, fibula, humerus, etc
Cortical (or compact) bone
Both types consists of
Cancellous (or spongy) bone
In a typical long bone (Such as femur) :
Diaphysis is composed of cortical bone surrounding medullary
cavity
Epiphyses mostly are cancellous bone & a thin rim of cortical
bone
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Normal Bones
is the basic structural unit of
cortical bone
It consists of
a central Haversian canal- blood vessels
- surrounding by lamelae of bone
anastomosing system of canals
Lamelae of Bone
Have a large number of
lacunae contain osteocytes
The Haversian System = Osteon
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Normal Bones
Periosteum : a connective tissue layer
(collagen), penetrate cortical bone
a tight attachment
together with large blood vessels & nerve
Cortex Separated by endosteum Marrow space (a thin layer of connective tissue)
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Methods of Biopsy
Open Biopsy
The most common method for diagnosing
bone tumors
Needle Biopsy
Effective & safe technique
A larger amount of tissue compare to FNAB
Fine Needle Aspiration Biopsy (FNAB)
The accuracy about 80% in bone tumors
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Diagnosis of Bone Lesions
Clinical datasor
diagnosis
Histopathological
diagnosis
Radiological
diagnosis
Frozen section :
- To check the tumor margins
- for metastatic tumor- to check the adequacy of
biopsy
- Name- Sex
- Age
- History
- Examination
- Lab. Findings- etc
- Location- Type of lesion
- Extension
- Periosteal -
reaction
- Calcification
- etc
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Basic Principles of Cancer Cytogenetics
In 1960 : The Philadelphia (Ph)chromosome in CML was discovered
In 1970 : Chromosomal Banding
techniques. Each chromosome could beidentified precisely
Tissue must be fresh not frozen or fixed informalinin sterile culture media :
Buffer sol (Hanks buffered salt solution)
Cytogenetic Analysis
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Bone Tumors
Classification, based on :
Cytologic features
The matrix
Benign tumors :
Malignant tumors : rarely arise from
benign ones
Incidence : 0,2% of all cancers were Bone
Sarcomas
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Bone Sarcoma
The most frequent : Osteosarcoma
Followed by :
Chondrosarcoma
Myeloma
Lymphoma
Ewing Sarcoma
Chordoma Fibrosarcoma
etc
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Surgical Margins
Radical The entire compartment involved by tumor is removed
Wide The tumor is removed with surrounding normal tissue
& the reactive zones (composed of the fibrovascularpseudocapsule) is removed intact
Marginal The tumor is removed entirely but the incision goes
through the reactive zone
Intra lesional The tumor is not removed intact & margins are
involved
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Entirely cartilage Malignant osteoid (-)
Pelvic, shoulder girdles,upper ends of the femur& humerus
More than 60% in thefourth-sixth decades
Radiographic Usually large size
75% calcification Mineralization shape, ring
shaped, popcorn like, orcomma shaped
Expansion of bone &thickening of cortex
Bone produced by thetumor cells
Malignant osteoid (+)
The metaphyseal regionof long bones (region of
the knee) The peak incidence is in
the second decade of life
Radiographic
Lytic Sclerotic
Codmans triangle
Cloud like
sunburst
CHONDROSARCOMA OSTEOSARCOMA
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