GPR: 2020 - Week 35

Clinical history

50 year old man with a history of multiple myeloma s/p bone marrow transplant and radiation.

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Osteosarcoma

Malignant bone neoplasm usually centered in the metaphysis.
Has a gritty cut surface that is tan-white to grey.
The mineralized bone will be tan-white and hard while the cartilaginous elements are greyish in color with a consistency ranging from mucinous if the matrix is myxoid and rubbery if the matrix is hyaline.

Recurrent Multiple Myeloma

Bone marrow based plasma cell neoplasm.
The classic gross appearance is a tan-red soft friable lesion that has fragile or eroded surrounding bone.

Chondrosarcoma

Can be low or high grade.
Low grade cartilaginous neoplasms can fill the medullary cavity and expand the bone causing thickening of the cortex.
While high grade chondrosarcomas can destroy the cortex and form soft tissue masses.
The cartilaginous areas are a glistening grey color and have a lobulated architecture that can be interspersed with thin fibrous septa.

Osteoblastoma

This is a benign bone forming neoplasm that is comprised of woven bone trabeculae and lined with osteoblasts.
Most frequently arises from appendicular skeleton and can be centered in either the cortex (65%) or medullary cavity (35%).
It usually presents as a solitary well circumscribed, tan white, dark red, and gritty boney mass that may have some cystic changes.

This week's Gross Pathology Roundup was presented by Leif Timothy Helland, MD on Mon, Aug 24, 2020.