Difference between revisions of "IPLab:Lab 7:Osteosarcoma"

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== Clinical Summary ==
 
== Clinical Summary ==
This 14-year-old white male first experienced mild pain in the left knee after playing baseball, approximately two months prior to admission. The pain persisted in an intermittent fashion, and was described as being somewhat worse at night. Approximately two weeks prior to admission, the pain increased significantly and was accompanied by marked swelling and loss of considerable motion of the knee joint. These symptoms were accompanied by a history of decreased appetite, lethargy, and a 10-pound weight loss. On physical examination, the left knee was enlarged diffusely, firm, and non-tender. Following biopsy, the patient was subjected to surgical removal of the distal femur and knee with placement of a prosthetic knee joint and bone grafts.
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This 14-year-old male first experienced mild pain in the left knee after playing baseball, approximately two months ago. The pain persisted in an intermittent fashion until approximately two weeks prior to admission, when the pain increased significantly and was accompanied by marked swelling and loss of motion. He also had decreased appetite, lethargy, and a 10-pound weight loss. On physical examination, the left knee was enlarged diffusely, firm, and non-tender. Radiographic and biopsy results confirmed a diagnosis of osteosarcoma.  The patient underwent surgical removal of the distal femur and knee with placement of a prosthetic knee joint and bone grafts.
  
== Autopsy Findings ==
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The distal diaphysis of the femur and adjacent soft tissues were involved in a 15 x 10 x 10-cm mass. The cut surface of the mass was fleshy white, with focal areas of hemorrhage.
The distal diaphysis of the femur and adjacent soft tissues were involved in a 15 x 10 x 10-cm mass. The cut surface of the mass was fleshy white, with focal areas of hemorrhage.  
 
  
 
== Images ==
 
== Images ==
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File:IPLab7Osteosarcoma5.jpg|These are cut sections of the distal femur containing the tumor. The periosteal involvement is evident from this picture (arrows).  
 
File:IPLab7Osteosarcoma5.jpg|These are cut sections of the distal femur containing the tumor. The periosteal involvement is evident from this picture (arrows).  
 
File:IPLab7Osteosarcoma6.jpg|This is a low-power photomicrograph of decalcified histologic section from this tumor. Note the blue color (cell nuclei stain blue) of much of this section indicating the increased cellularity of the tumor.  
 
File:IPLab7Osteosarcoma6.jpg|This is a low-power photomicrograph of decalcified histologic section from this tumor. Note the blue color (cell nuclei stain blue) of much of this section indicating the increased cellularity of the tumor.  
File:IPLab7Osteosarcoma7.jpg|This is a higher-power photomicrograph of decalcified histologic section from this tumor. There are areas of osteoid (1) and cellular areas (2).
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File:IPLab7Osteosarcoma7b.jpg|This is a photomicrograph of a decalcified histologic section from normal bone. Compare this normal morphology to the subsequent images of bone in this case of osteosarcoma.
File:IPLab7Osteosarcoma8.jpg|This is a high-power photomicrograph of decalcified histologic section showing the cellularity of the tumor.  
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File:IPLab7Osteosarcoma8b.jpg|This is a higher-power photomicrograph of decalcified histologic section from this tumor. There are areas of osteoid (1) and cellular areas (2).
File:IPLab7Osteosarcoma9.jpg|This high-power photomicrograph demonstrates the cellular growth pattern. Note that the cells are fusiform and they grow in sheets.  
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File:IPLab7Osteosarcoma9b.jpg|This is a higher-power photomicrograph of decalcified histologic section showing the cellularity of the tumor.  
File:IPLab7Osteosarcoma10.jpg|This high-power photomicrograph demonstrates the growth pattern and the cell morphology.
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File:IPLab7Osteosarcoma10b.jpg|This higher-power photomicrograph demonstrates the cellular growth pattern. Note that the cells are pleomorphic and anaplastic.  
File:IPLab7Osteosarcoma11.jpg|This is a high-power photomicrograph of the tumor cell morphology and the periosteum (arrow).
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File:IPLab7Osteosarcoma11b.jpg|This high-power photomicrograph demonstrates the anaplastic cell morphology.
File:IPLab7Osteosarcoma12.jpg|This high-power photomicrograph of the tumor demonstrates the fusiform morphology of the cells. Note the marked variability in size and staining intensity of the nuclei.
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File:IPLab7Osteosarcoma12b.jpg|This is a high-power photomicrograph of the tumor demonstrating the anaplastic cell morphology and mitotic figures (arrows).  
File:IPLab7Osteosarcoma13.jpg|This is a high-power photomicrograph of the tumor demonstrating the anaplastic cell morphology.
 
File:IPLab7Osteosarcoma14.jpg|This is a high-power photomicrograph of the tumor demonstrating the anaplastic cell morphology.  
 
File:IPLab7Osteosarcoma15.jpg|This is a high-power photomicrograph of the tumor demonstrating the anaplastic cell morphology and multiple mitotic figures (arrows).  
 
 
</gallery>
 
</gallery>
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== Virtual Microscopy ==
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<peir-vm>IPLab7Osteosarcoma</peir-vm>
  
 
== Study Question ==
 
== Study Question ==
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=== Images ===
 
=== Images ===
 
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* [{{SERVER}}/library/index.php?/tags/797-osteosarcoma PEIR Digital Library: Osteosarcoma Images]
 
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* [http://library.med.utah.edu/WebPath/NEOHTML/NEOPLIDX.html#5 WebPath: Malignant Neoplasms -- Examples of Sarcomas]
== Related IPLab Cases ==
 
 
 
  
 
{{IPLab 7}}
 
{{IPLab 7}}
  
 
[[Category: IPLab:Lab 7]]
 
[[Category: IPLab:Lab 7]]

Latest revision as of 21:07, 9 July 2020

Clinical Summary[edit]

This 14-year-old male first experienced mild pain in the left knee after playing baseball, approximately two months ago. The pain persisted in an intermittent fashion until approximately two weeks prior to admission, when the pain increased significantly and was accompanied by marked swelling and loss of motion. He also had decreased appetite, lethargy, and a 10-pound weight loss. On physical examination, the left knee was enlarged diffusely, firm, and non-tender. Radiographic and biopsy results confirmed a diagnosis of osteosarcoma. The patient underwent surgical removal of the distal femur and knee with placement of a prosthetic knee joint and bone grafts.

The distal diaphysis of the femur and adjacent soft tissues were involved in a 15 x 10 x 10-cm mass. The cut surface of the mass was fleshy white, with focal areas of hemorrhage.

Images[edit]

Virtual Microscopy[edit]

Study Question[edit]


Additional Resources[edit]

Reference[edit]

Journal Articles[edit]

Images[edit]

The normal fibrinogen level is 184 to 412 mg/dL.