General References. Epithelioid Sarcoma. 566 x. Tumors and Tumorlike Lesions of the Synovial Membrane

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1 566 x. Tumors and Tumorlike Lesions of the Synovial Membrane Epithelioid Sarcoma Bliss BO, Reed RJ (1968) Large cell sarcomas of tendon sheath. Malignant giant cell tumors of tendon sheath. Am J Clin Pathol 49: Bryan RS, Soule EH, Dobyns JH, Pritchard DJ, Linscheid RL (1974) Primary epithelioid sarcoma of the hand and forearm. A review of thirteen cases. J Bone Joint Surg [Am] 56: Enzinger FM (1970) Epithelioid sarcoma. A sarcoma simulating a granuloma or a carcinoma. Cancer 26: Enzinger FM (1977) Recent developments in the classification of soft tissue sarcoma. In: Management of primary bone and soft tissue tumors. Yearbook Medical Publishers, Chicago, pp Fisher ER, Horvat B (1972) The fibrocytic derivation of the so-called epithelioid sarcoma. Cancer 30: Frable WJ, Kay S, Lawrence W, Schatzki PF (1973) Epithelioid sarcoma. An electron microscopic study. Arch PathoI95:8-12 Gabbiani G, Fu YS, Kaye GI, Lattes R, Majno G (1972) Epithelioid sarcoma. A light and electron microscopic study suggesting a synovial origin. Cancer 30: Santiago H, Feinerman LK, Lattes R (1972) Epithelioid sarcoma. A clinical and pathologic study of nine cases. Hum Pathol 3: Soule EH, Enriquez P (1972) Atypical fibrous histiocytoma, malignant fibrous histiocytoma, malignant histiocytoma, and epithelioid sarcoma. A comparative study of 65 tumors. Cancer 30: General References Ackerman LV, Spjut HJ (1962) Tumors of bone and cartilage. Atlas of tumor pathology, Fasc 4. Armed Forces Institute of Pathology, Washington DC Aegerter E, Kirkpatrick JA, Jr (1975) Orthopedic diseases: Physiology, pathology, radiology, 4th edn. Saunders, Philadelphia Barry HC (1969) Paget's disease of bone. Livingstone, Edinburgh Brachetto Brian D (1966) Tumores de los huesos. Editorial Universitaria, Buenos Aires Coley BL (1960) Neoplasms of bone and related conditions: Their etiology, pathogenesis, diagnosis and treatment, 2nd edn. Harper (Hoeber), New York Dahlin DC (1978) Bone tumors, 3rd edn. Thomas, Springfield, Illinois Dominok GW, Knoch HG (1977) Knochengeschwiilste und geschwiilstahnliche Knochenerkrankungen, 2nd edn. Fischer, Jena Edeiken J, Hodes PJ (1977) Roentgen diagnosis of disease of bone. Williams & Wilkins, Baltimore, Maryland Fairbanks T (1951) An atlas of general affections of the skeleton. Livingstone, Edinburgh Fraumeni JF, Jr (1967) Stature and malignant tumors of bone in childhood and adolescence. Cancer 20: Geschickter CF, Copeland MM (1949) Tumors of bone, 3rd edn. EM Lippincott, Philadelphia Gilmer WW, Highley GB, Kilgore WA (1963) Atlas of bone tumors. St Louis Missouri Glass AG, Fraumeni JF (1970) Epidemiology of bone cancer in children. JNCI 44: Greenfield GB (1969) Radiology of bone disease. Li ppincott, Philadelphia Grundmann E (edr) (1976) Malignant bone tumors (Recent Results in Cancer Research, Vol 54). Springer-Verlag, Berlin-Heidelberg-New York Hellner H (1950) Die Knochengeschwiilste, 2nd edn. Springer-Verlag, Berlin-Heidelberg-New York Hirohata K, Morimoto K (1977) Ultrastructure of bone and joint diseases. Grune & Stratton, New York Huvos AG (1979) Bone tumors. Diagnostic, treatment and prognosis. Saunders, Philadelphia Jaffe HL (1958) Tumors and tumorous conditions of the bones and joints. Lea & Febiger, Philadelphia Jaffe HL (1972) Metabolic, degenerative and inflammatory diseases of bone and joints. Lea & Febiger, Philadelphia Jaffe N (ed) (1979) Progress in pediatric hematology oncology, Vol II. Bone Tumors in Children. Publishing Science Group, Acton, Massachusetts Kolodny A (1927) Bone sarcoma. The primary malignant tumors of bone and the giant cell tumor. Surg Gynecol Obstet 44: 1, Suppl 1 Larsson SE, Lorentzon R (1974) The geographic variation of the incidence of malignant primary bone tumors in Sweden J. Bone Joint Surg [Am] 56: Lichtenstein L (1977) Bone tumors, 5th edn. Mosby, St Louis, Missouri Lodwick GS (1965) A systemic approach to roentgen diagnosis of bone tumors. Tumors of bone and soft tissues. Yearbook Medical Publishers, Chicago MacKenzie A, Court Brown W, Doll R, Sissons HA (1961) Mortality from primary tumors of bone in England and Wales. Br Med J 1:

2 References Milch RA, Changus GW (1956) Response of bone to tumor invasion. Cancer 9: 340 Murray RO, Jacobson HG (1971) The radiology of skeletal disorders. Williams & Wilkins, Baltimore, Maryland Netherlands Committee on Bone Tumours (1966) Radiological atlas of bone tumors, Vol I. Williams & Wilkins, Baltimore, Maryland Netherlands Committee on Bone Tumours (1973) Radiological atlas of bone tumors, Vol II. Williams & Wilkins, Baltimore, Maryland Nielsen SW (1976) Comparative pathology of bone tumors in animals with particular emphasis on the dog. Recent Results Cancer Res 54:3-16 Owen LN (1969) Bone tumours in man and animals. Butterworth, London Paget J (1853) Lectures on surgical pathology, Vol 2. Longmans, Green, New York Pique JA, Schajowicz F (1948) Tumores de los huesos. EI Ateneo, Buenos Aires Price CHG, Ross FGM (eds) (1973) Bone, certain aspects of neoplasia. Proceedings of the 24th Symposium of the Colston Research Society. Butterworth, London Ranninger K (ed ) (1977) Diseases of the skeletal system (Roentgen diagnosis): Part 6, Bone tumors. Springer-Verlag, Berlin-Heidelberg-New York Schajowicz F (1959) Tumores malignos primitivos de los huesos. Anat Pathol 30th Argent Cong Surg pp Schajowicz F, Ackerman LV, Sissons HA (1972) Histological typing of bone tumors. International histological classification of tumors, No.6. W orid Health Organization, Geneva Sissons HA (1977) Population studies of bone tumours. Proc Soc Med 64: Sissons HA, Duthie RB (1959) A survey of the biological properties of tumours of bone. In: Rock CE, Ross JP (eds) British surgical progress. Butterworth, London, pp Spjut HJ, Dorfman HD, Fechner RE, Ackerman LV (1971) Tumors of bone and cartilage. Atlas of tumor pathology, 2nd ser, Fasc 5. Armed Forces Institute of Pathology, Washington, DC Trifaud A, Meary R (1972) Pronostic et traitment des sarcomes osteogeniques. Masson, Paris Uehlinger E (1973) Pathologische Anatomie der Knochengeschwiilste. Helv Chir Acta 40: 5 Valls J, Ottolenghi CE, Schajowicz F (1942) La biopsia por aspiracion en el diagnostico de las lesiones oseas. El Ateneo, Buenos Aires Virchow R ( ) Die krankhaften Geschwiilste, 2nd vol. Hirschwald, Berlin Weinmann JP, Sicher H (1947) Bone and bones. Fundamentals of bone biology. Mosby, St. Louis, Missouri Willis RA (1953) Pathology of tumours, 2nd edn. Butterworth, London

3 Index Acid phosphatase 227 Adamantinoma clinical findings 385 incidence 384 pathogenesis pathologic features 385, 389 prognosis radiographic features 385 treatment Adenomas 500 Adipose tissue 339 Age adamantinoma 385 aneurysmal bone cyst 427 brown tumor of hyperparathyroidism 500 chondroblastoma 135, 136 chondroma llo multiple 120 chondromyxoid fibroma 150 chondrosarcoma primary 161 secondary 178 chordoma 376 clear-cell chondrosarcoma 195 clear-cell sarcoma 559 desmoplastic fibroma 335 diffuse articular lipomatosis 545 eosinophilic granuloma , 479 epidermoid cysts 507 epithelioid sarcoma 559 Ewing's sarcoma fibrosarcoma 343 fibrous histiocytoma, malignant 366 giant-cell tumor hemangioma 303, 546 juxta-articular bone cysts 442 juxtacortical osteosarcoma Letterer-Siwe syndrome 467 lipoma 339, 546 liposarcoma 360 massive osteolysis 317 mesenchymoma, malignant 362 metaphyseal fibrous defect multifocal osteosarcoma 84 myeloma 281 myositis ossificans 491 neurilemmoma 389 osteoblastoma, genuine 47 osteochondroma 124 multiple 132 osteoid osteoma 36 osteosarcoma 65 Paget's sarcoma 401 peripheral osteosarcoma reticulosarcoma solitary bone cyst 419 synovial chondroma 548 synovial chondromatosis 532 synovial sarcoma 55 1 Alkaline phosphatase activity 66, 83 Amputation specimens Amyloidosis 296 Anatomic site see Localization Aneurysmal bone cyst (multiocular hematic bone cyst) clinical findings 427 definition 426 incidence 427 pathogenesis 436, 441 pathologic findings 431, 433, 436 prognosis 441 radiographic findings treatment 441 Angioblastic origin 389 Angioblastoma, malignant 389 Angiography 3 Angiosarcoma 319, 329 Annular sequestrum 4 1 Antoni A and B type tissue 392 Arthritis 36 Articular lipomatosis, diffuse Aspiration biopsy 5-6, 8, 15, 370 figures 7, 9-14 histochemical studies 6, 8 recommended method

4 570 Basaloid histologic pattern 389 Benign, adjective 56 Benign osteoblastoma, Jee Osteoblastoma, genuine Benign tumors low-grade malignant versus 109 malignant transformation of, Jee Malignant transformation metastases 148 Biochemistry brown rumor of hyperparathyroidism 500 chondrosarcoma 176 osteosarcoma 84 Biologic behavior, histologic appearance versus 109 Biopsy 3-16 aspiration, Jee Aspiration biopsy cartilaginous rumor 176 prior radiation 4 surgical 4-5 Body-section radiography (tomography) 3 Bone caviry caused by ganglion 441 Bone cyst aneurysmal, Jee Aneurysmal bone cyst juxta-articular, Jee Juxta-articular bone cyst latent and active 421 solitary, Jee Solitary bone cyst simple 424 Bone formation, tumor versus reactive 82 Bone-forming rumors benign, Jee Osteoblastoma; Osteoid osteoma; Osteoma malignant, Jee Juxtacortical osteosarcoma; Osteosarcoma Bone scan (scintigraphy) 3 Bone sclerosis 285, 289 Bone-seeking radionuclides 409 Bone specimens, handling Bone tumors classification of, Jee Classification of bone tumors histologic types 243 C-type RNA virus Calcifying and ossifying chondtomas 111, 117 Calcifying giant-cell tumor 135 Caloric source Cancellous osteoblastoma Capsulo-synovial intraosseous inclusions 442 Cartilage-forming tumors benign chondroblastoma, Jee Chondroblastoma chondroma, Jee Chondroma chondromyxoid fibroma 148, 160 dysplasia epiphysealis hemimelica 134 osteochrondroma, jee Osteochondroma table of 109 biologic behavior versus histologic appearance 109 malignant chondrosarcoma, Jee Chondrosarcoma juxtacortical chondrosarcoma 179, mesenchymal chondrosarcoma Cartilage tumor criteria for malignancy 167, 174 osteosarcoma 72, 74 Cartilaginous tumor, biopsy 176 CAT scan (computerized axial tomography) 3 Index Cellular pleomorphism 74 Chelating agents 16 Chemotherapy eosinophilic granuloma 480 Ewing's sarcoma 264 myeloma 298 peripheral osteosarcoma 88 Chondroblastic osteosarcoma 65, 80 Chondroblastoma 21, age 135, 136 benign and malignant varieties 135 chondromyxoid fibroma, transitional stages 146 clinical findings cystic 146 defini tion 135 electron microscopy 147 histochemistry 147 histopathology incidence 135 malignant transformation 148 pathogenesis pathology 137, prognosis 148 radiographic features 137 treatment 135, 148 Chondroma , 380 calcifying and ossifying 111 clinical findings 110 definition 110 fibromyxoid, Jee Chondromyxoid fibroma hands and feet 113 incidence 110 juxtacortical malignant transformation 113, multiple clinical findings 120 malignant transformation 121 pathology 121 prognosis 121 radiographic features treatment 121 pathologic findings prognosis 113, 115 radiographic features treatment 113, 115 Chondroid chordomas 382 Chondroid substance, transitional stage 146 Chondromyxoid fibroma (fibromyxoid chondroma) 21, 148, chondroblastoma, transitional stages 146 clinical findings fibromyxoid chondroma, term 158 histopathology 154, incidence 148 malignant transformation 160 pathogenesis 158 pathologic findings prognosis radiographic features treatment Chondrosarcoma , 382, 384, 519 biochemistry 176

5 Index biopsy 176 classification, table of 161 clear-cell variant 195 dedifferentiated definition 160 electron microscopy 176 genesis 163 incidence 176 mesenchymal postradiation 407 primary central clinical findings 161, 163 hands and feet histologic features 167, l74, 176 osteosarcomas versus pathologic features radiographic features prognosis secondary l79 treatment Chordoma clinical findings definition 378 differential diagnosis 382, 384 electron microscopy 382, 384 hisrogenesis 382, 384 incidence 376 pathologic findings prognosis 384 radiographic findings 379 treatment 384 Circumscribed osteoblastoma, see Osteoid osteoma Classification of bone tumors Aegerter and Kirkpatrick concept 21 cytologic 18 Ewi[\g 17 histogenetic 18 table of 18 tumorlike lesions, table of 21 WHO system 18-19, 21 table of 19 Clear-cell chondrosarcoma 195 Clear-cell sarcoma 559 Clinical-histologic correlation 229, Codman's triangle 68 Collagen, types 84 Collagenolytic activity 74 Computerized axial tomography (CAT scan) 3 Computerized tomography 167 Connective tissue tumors benign desmoplastic fibroma, see Desmoplastic fibroma lipoma malignant ; see also Fibrosarcoma; Fibrous histiocytoma liposarcoma' 360 mesenchymoma, malignant 330, 362 Corticalosteoblastoma 35,48-52 Cryosurgery 115 Cystic angiomatosis (hamartous hemolymphangiomatosis) of bone 309, 311, 317 Cystic chondroblastoma 146 Cytologic classification Decalcification, specimen handling 15 Dedifferentiated chondrosarcoma , 362 Definition adamantinoma 384 aneurysmal bone cyst 426 chondroblastoma 135 chondroma 110 chondrosarcoma 160 chordoma 376 desmoplastic fibroma 335 eosinophilic granuloma 466 Ewing's sarcoma 244 fibrosarcoma 342 fibrous dysplasia 480 giant-cell tumor 205 hemangioendothelioma 319 hemangioma 303 hemangiopericytoma 327 juxtacortical chondrosarcoma 179 lipoma 339 liposarcoma 360 mesenchymal chondtosarcoma 191 metaphyseal fibrous defect 45 1 myeloma 281 myositis ossificans 490 neurilemmoma 391 osteochondroma 121 osteoid osteoma 36 osteoma 25 osteosarcoma 65 reticulosarcoma 267 solitary bone cyst 419 Demineralization 15 Dermal inclusion tumor 389 Desmoplastic fibroma definition 335 differential diagnosis 335, 339 pathology 335, 339 radiographic features 335 treatment 339 Diagnosis 2-3 alkaline phosphatase activity 66 benign versus low-grade malignant 109 btown tumor of hyperparathyroidism 500, 503 chordoma 382, 384 clinical findings 335 desmoplastic fibroma versus metaphyseal fibrous defect 335,339 eosinophilic granuloma versus reticulosarcoma 475 epidermoid cysts 5 10 error in, source of 5 Ewing's sarcoma 263 reticulosarcoma versus ,252,272,273 fibrous histiocytoma 366, 370 giant-cell tumor 205, 224 glycogen 252, histochemistry 16 intrasosseous lipoma 341

6 572 Diagnosis [cont.} juxta-articular bone cysts 448 juxtacortical chondrosarcoma juxtacortical osteosarcoma 99, 10 1 Letterer-Siwe syndrome 467 marrow puncture 282 myeloma 296 neurofibroma versus neurilemmoma 397 osteoblastoma versus osteoid osteoma 35-36, 48-49, 56 osteoblastoma versus osteosarcoma 49,52,61-62 osteoid osteoma versus arthri tis 36 postradiation sarcoma, criteria for 409 radiology in 2-3 synovial sarcoma 527, 552 Diffuse articular lipomatosis Disappearing bone 3 17 Dyaphyseal aclasis 132 Dyschondroplasia 1l0, 117 Dysplasia epiphyseal is hemimelica 134 Eccentric chondrosarcoma 179, 186 Eccentric osteosarcoma 187 Ecchordosis physaliphora 376 Ectodermic origin 389 EDTA 15 Electrolytic decalcification 15 Electron microscopy chondroblastoma 147 chondrosarcoma 176 chordoma 382, 384 Ewing's sarcoma giant-cell tumor 227 mesenchymal chondrosarcoma 194 myeloma osteosarcoma reticulosarcoma Electrophoretic studies 282 Embedding in paraffin 5 Enchondtoma , 177 calcifying and ossifying 117 Enchondromatosis, multiple Endothelial myeloma 243 Endothelioma of bone, diffuse 243 Enostosis, see Osteoma, medullary Enzymatic activity 16, 74 Eosinophilic granuloma clinical findings definition 466 differential diagnosis 475 histopathology-clinical correlation incidence 467 pathologic findings 470, radiographic features unified c ~ n c e , p t 479 Epidermoid cysts of bone 507, 510 Epiphyseal chondtoblastoma 135 Epiphyseal chondtomatous giant-cell tumor 135 Epithelial cysts 507 Epithelioid sarcoma 559, 561 Index Ethylenediaminetetracetic acid (EDT A) 15 Etiology 2; see also Pathogenesis; Postradiation malignant transformation; Trauma adamantinoma 385, 389 aneurysmal bone cysts 436, 441 diffuse articular lipomatosis 545 epidermoid cysts 5 10 giant-cell tumor 227 myositis ossificans 490 osteosarcoma preexisting bone lesions, see Preexisting bone lesions synovial chondromatosis 541 trauma, see Trauma Ewing's sarcoma 80, , 252, , 267 clinical findings definition 244 differential diagnosis ,252,263,272,273 electron microscopy incidence 244 pathogenesis pathologic findings 246, 252, prognosis , 267 radiographic features treatment , 267 Exostosing form of osteoid osteoma 52 Extra-skeletal Ewing's sarcoma 261 F. B. J. osteosarcoma virus 86 Fatty tumors 339 Fibroblastic osteosarcoma 65, 80, 342 Fibtoma 548 nonossifying, see Metaphyseal fibrous defect Fibromyxoid chondroma, see Chondromyxoid fibroma Fibroosteoma 488 Fibrosarcoma 339, clinical findings congenital 343, 345 definition 342 graded 354, 360 incidence 343 metastases 345 multifocal 345 Paget's disease 343 pathologic findings 345, 354, 360 ptognosis 360 radiographic features 345 secondary 343 treatment 360 F ibtous dysplasia 419, clinical findings 480, 481, 486 definition 480, 486, 488 malignant transformation 490 pathologic findings 486, 488 Fibtous dysplasia-like lesions 389 Fibrous histiocytoma, malignant (fibroxanthosarcoma) 19, 360, 362, clinical findings 366 diagnosis 366, 370 pathologic findings 370 prognosis 370, 373

7 Index radiologic features 366, 370 treatment 370, 373 Fibrous lesions 419 Fibrous osteodystropy 419, 424 Fibrous osteomyelitis, chronic 451 Fibroxanthoma, synovial membrane 5 19 Fibroxanthosarcoma, see Fibrous histiocytoma Freezing 16 Frozen section 5 Gallium 67 citrate 3 Ganglia affecting bone 442 Ganglion cysts of bone 442 Gardner's syndrome 34 Genetic factors Giant-cell granuloma 207 Giant-cell reaction of bone 224 Giant-cell synovioma, benign 519 Giant-cell tumor (osteoclastoma) ,519 acid phosphatase content 227 clinical findings , 216 clinical-histologic correlation 229 as complication of Paget's disease definition 205 diagnosis 205, 224 electron microscopy 227 etiology 227 grading 229 healing reaction in 220 histochemistry 224, 227 incidence localization 207, 216 malignant 229, 232 multicentric 216 osteoclastoma, term 228 pathogenesis pathology 217, 220, 224 prognosis 220 radiographic features symptoms 216 terminology 228 treatment 232, 237 types 229 variants of, table of 205 xanthomatous type 237 Giant cells, malignant Giant tumors, malignant Glomangioma Glomus tumor (glomangioma) Glycogen 252, Grading fibrosarcoma 354, 360 giant-cell tumor 229 hemangioendothelioma 3 19 prognosis 229, 360 Hamartoma, definition 21 Hamartous hemolymphagniomatosis 309, 311, 317 Hand-Schiiller-Christian syndrome , 468, 470, 476, Hard parts of specimen 15 Height 65 Hemangioendothelioma clinical findings 320 definition 319 grading 319 incidence 319 pathologic findings , 325 prognosis 325 radiographic findings Stout's criteria 319 treatment 325 Hemangioma 120, , 546 clinical findings 303 cystic angiomatosis 309, 311, 3 17 definition 303 incidence 303 massive osteolysis 317 pathologic features 304, 309 radiographic features treatment 309 Hemangiomatosis, diffuse skeletal 309 Hemangiopericytoma 194, 327 Hematic bone cyst, multiocular, see Aneurysmal bone cyst Hemorrhagic osteosarcoma 75 Hereditary deforming chondrodysplasia 132 Heredity 163 Heterotopic ossification, see Myositis ossificans Histochemistry 16 Histochemical studies aspiration biopsy 6, 8 chondroblastoma 147 Ewing's sarcoma 252, giant-cell tumor 224, 227 myeloma 291,293 Histiocytic granuloma 466, 467 Histiocytic xanthogranuloma 335, 339; see also Metaphyseal fibrous defect; Nodular synovitis, localized Histiocytosis 466 Histiocytosis X 3 11 Histogenesis chordoma 382, 384 clear-cell sarcoma 559 epi thelioid sarcoma 561 juxta-articular bone cyst 446, 448 Histogenetically based classification system 18 Histologic appearance adamantinoma 385, 389 aneurysmal bone cysts 433, 435 biologic behavior versus 109 brown tumor of hyperparathyroidism 500 chondrosarcoma 167, 174, 176 clear-cell chondrosarcoma 195 clear-cell sarcoma 559 diffuse articular lipomatosis 546 eosinophilic granuloma 470, epidermoid cysts 507 epithelioid sarcoma 559 fibrosarcoma 354, 360 freezing of specimen 16 giant-cell tumor 220, 224 hemangioma 309, 546

8 574 Histologic appearance {cont,} hemangioendothelioma ,325 juxta-articular bone cysts juxtacortical chondroma 117 lipoma 341 localized nodular synovitis 526 metaphyseal fibrous defect 453, 455 myeloma myositis ossificans neurilemmoma 392 osteoid osteoma 41, 47 Paget's sarcoma 405 solitary bone cyst synovial chondroma 548 synovial chondromatosis 541 synovial sarcoma Histologic-clinical correlation 229, Histologic criteria of malignancy 167, 174 Histologic pattern Antoni A and B types 392 various 243, 389 Histopathology chondroblastoma chondroma 113 chondromyxoid fibroma 154, Ewing's sarcoma 246 juxtacortical osteosarcoma mesenchymal chondrosarcoma 194 osteochondroma 127, reticulosarcoma Hoffa's disease 546 Hyperparathyroidism acid phosphatase 227 brown tumor of hyperparathyroidism 500, 503 Immunoallergic reaction 479 Immunoelectrophoretic studies 282 Immunotherapy Incidence adamantinoma 384 aneurysmal bone cyst 427 angiosarcoma 329 chondroblastoma 13 5 chondroma 110 chondromyxoid fibroma 148 chondrosarcoma 176 chordoma 376 difficulties in obtaining 1 eosinophilic granuloma 467 Ewing's sarcoma 244 fibrosarcoma 343 fibrous histiocytoma, malignant 366 giant-cell tumor giant-cell tumor as complication of Paget's disease hemangioma 303 hemangioendothelioma juxta-articular bone cysts juxtacortical chondroma juxtacortical osteosarcoma 95 lipoma 339 lymphosarcoma 268 mesenchymal chondrosarcoma 191 metaphyseal fibrous defect 451 myeloma 281 osteochondroma 124 osteosarcoma 65 osteoid osteoma 36 Paget's disease 401 Paget's sarcoma 401 reticulosarcoma 268 soli tary bone cyst 4 19 table of 20 Infectious agents 87 Intracapsular chondroma 548 Intramarrow spread Intraosseous cystic lesions 507 Intraosseous ganglion, see also Juxta-articular bone cyst osteoarthritic lesions versus 446, 448 types of 444 Intraosseous lipoma 339, 341 Intraosseous mucous cysts 442 Ionizing radiation 2, 409 Ivory exostosis, see Osteoma, classic Jaw bones 207 Juxta-articular bone cyst (intraosseous ganglion) clinical findings 442 differential diagnosis 448 histogenesis 446, 448 incidence 442 pathogenesis 444, pathologic findings prognosis 45 1 radiographic features synovial type 446 treatment 451 Juxtacortical chondroma incidence 116 location 116 pathologic findings radiographic findings sex 16 term 115 treatment Juxtacortical chondrosarcoma 179, definition 179 differential diagnosis 86, peripheral osteosarcoma versus 86 Juxtacortical (parosteal) osteoma 25, 27, 34 Juxtacortical (parosteal) osteosarcoma clinical findings definition 95 differential diagnosis 99, 10 1 incidence 95 pathologic finding prognosis 95, radiographic features treatment Index

9 Index Kidney, myeloma of 298 Lemmocito-fibtoma 394 Lemmocytoma 391 Letterer-Siwe syndrome 467, 468, 478, 479 Leukemia 282 Lipoid granulomatosis 45 1 Lipoma , 546 Lipoma arborescens 5 19, 544, 546 Lipomatosis, diffuse 519 Liposarcoma 360, 362 Localization adamantinoma 385 aneurysmal bone cyst 427 chondroblastoma chondtoma 1 10 chondromyxoid fibroma 150 chondrosarcoma primary 161 secondary 176 chordoma clear-cell chondrosarcoma 195 cystic angiomatosis 3 11 desmoplastic fibroma 335 diffuse articular lipomatosis 545 eosinophilic granuloma epithelioid sarcoma 559 Ewing's sarcoma 245 fibrosarcoma 345 fibrous histiocytoma, malignant 366 giant-cell tumor 207, 216 glomus tumor 317 hemangioma 303, 546 hemangiopericytoma 327 juxta-articular bone cysts 442 juxtacortical chondroma 116 juxtacortical osteosarcoma 96 lipoma 339, 546 localized nodular synovitis 521 massive osteolysis 3 17 metaphyseal fibrous defect 452 multifocal osteosarcoma 84 myeloma 281 myositis ossificans 491 neurofibroma 394 neurilemmoma 391 osteochondroma, multiple 132 osteoid osteoma 36 osteoblastoma, genuine 47 osteochondroma 124 osteosarcoma Paget's sarcoma pigmented villonodular synovitis 526 prognosis 90 reticulosarcoma' 269 solitary bone cyst 419 synovial chondromatosis 532 synovial sarcoma 55 1 Localized nodular synovitis Lymphagioma Lymphatic metastases 90, 93 Lymphocytic infiltration 220, 224 Lymphoma of bone, see Lymphosarcoma; Reticulosarcoma Lymphoreticular neoplasmas, classification of 268 Macroglobulinemia, Waldenstrom's 293 Mafucci's syndrome 110, 120 Malignancy benign versus low-grade 109 criteria 167, 174 Malignant giant tumor Malignant mesenchymoma 80 Malignant transformation, see also Postradiation sarcoma benign, adjective 56 chondroblastoma 148 chondroma 113 multiple 12 1 solitary chondtomyxoid fibroma 160 fibrous dysplasia 490 metaphyseal fibtous defect 460 osteoblastoma 56 osteochondroma 127, 132 multiple 133 Paget's disease 75 synovial chondromatosis 539, 543 Marrow tumors 282; see also Ewing's sarcoma; Lymphosarcoma; Myleoma; Reticulosarcoma Massive osteolysis 3 17 Medullary (cancellous) osteoblastoma 34, Medullaryosteoma 25, 34 Melanin pigment 559 Mesenchymal chondrosarcoma 80, ,263 clinical features definition 191 histopathology 194 incidence 191 pathologic findings prognosis 194 radiologic features treatment 194 Mesenchymoma, malignant 80, 360, Metaphyseal aclasis 132 Metaphyseal fibrous defect (nonossifying fibroma/histiocytic xanthogranuloma) 335,339, clinical findings definition 451 incidence 451 malignant transformation 462 pathogenesis 455, 462 pathologic findings 453, 455 prognosis 462 radiographic findings treatment 462 Metastases adamantinoma benign tumors 148 chondrosarcoma 177 chordoma 384

10 576 Index Metastases {cont. J desmoplastic fibroma 339 fibrosarcoma 345 other bones 93 peripheral osteosarcoma 88, reticulosarcoma 277 synovial sarcoma 553 Methylprednisolone 426 Microangiographic technique 74 Microscopy, electron, see Electron microscopy Monostotic fibrous dysplasia Mortality, 1; see also Prognosis Mucin 382 Multifocal osteosarcoma 84 Multifocal sclerosing osteoblastoma Multilocular hematic bone cyst, see Aneutysmal bone cyst Multiple chondroma, see Chondroma, multiple Myeloma amyloidosis 296 clinical findings 281 definition 281 diagnosis 296 electron microscopy extra-skeletal histology incidence 281 kidney 298 multiple 281 nonsecretory 282 pathologic findings prognosis radiographic features sclerotic 285, 289 solitaty (localized) 281, stages 290 treatment 298 Myelomatose diffuse decalcificante 285 Myelomatosis, diffuse 285, 289, 298 Myositis ossificans (heterotopic ossification) 52, 99, classification of, table of 491 clinical findings 491 definition 490 etiology 490 pathologic findings prognosis 498 radiologic features treatment 498 types 490 Myxoid chondrosarcoma 382 Myxoma 148 Necrobiotic pseudocyst 441 Needle biopsy, see Aspiration biopsy Neurilemmoma (schwannoma/neurinoma) , 397 Neurinoma Neuroblastoma 263 Neurofibroma Neurofibromatosis (von Recklinghausen's disease) 394,488 Nidus mineralization of 41,47 osteoid osteoma 41 size 36 Nodular synovitis, localized 519, Nonossifying fibroma, see Metaphyseal fibrous defect Nonosteogenic fibroma 451 Nonsecretoty myeloma 282 Oilier's disease 110, 120 Ossifying fibroma 488 Ossifying parosteal sarcoma 95 Osteitis fibrosa 419, 424 Osteitis fibrosa cystica 486, 488 Osteoarthritic lesions 446, 448 Osteoblastic osteosarcoma 65, 80 Osteoblastoma, genuine (osteoblastomal benign osteoblastoma) 35-36,47-62 age 47 circumscribed, see Osteoid osteoma classification of, table of 54 cortical 35,48-52 differential diagnosis 35-36, 56, localization malignant transformation 56 medullaty (cancellous) multifocal sclerosing osteoid osteoma versus 48-49, 52, 56,61-62 peripheral (periosteal) 52 recurrence 56 sex 47 spongious 35 symptoms 47 Osteoblastoma, malignant 56, prognosis treatment 62 Osteocartilaginous exostosis, see Osteochondroma Osteochondroma 121, clinical findings definition 121 epiphyseal 134 histopathology 127, incidence 124 juxtacortical osteosarcoma versus 10 1 malignant transformation 127, 132, 133 multiple pathogenesis 132 pathologic findings pedunculated type 125, 132 prognosis 132, 133 radiation therapy 132 radiographic features recurrence 13 2 sessile type 125, 127, 132 treatment 132, 133 Osteochondromatosis 519 Osteoclastoma, see Giant-cell tumor Osteogenic fibroma 35 Osteogenic sarcoma 65 Osteoid substance, transitional stage 146

11 Index Osteoid osteoma (circumscribed osteoma) 29, clinical findings 36 definition 36 differential diagnosis exostosing form 52 histologic findings 41, 47 incidence 36 multifocal osteoblastoma versus 48-49, 56 pathologic findings 41, 47 radiographic features 36, 41 spine 36 symptoms 36, 47 types 36, 41 typical Osteoliposarcoma 362 Osteolysis, massive 317 Osteolytic osteosarcoma 68 Osteoma clinical findings 25,27,29 conventional classic 25 definition 25 juxtacortical (parosteal) 25, 27, 34 medullary 25, 34 osteoid, see Osteoid osteoma pathologic findings 29, 34 treatment 34 types of 25 Osteomyelitis 245 Osteosarcoma 65-95, 362 Aegerter and Kirkpatrick classes 80 biochemistry 84 cartilage 72, 74 categories 65 chondrosarcoma versus clinical findings definition 65 electron microscopic studies etiology hemorrhagic 75 histochemical features 83 incidence 65 juxtacortical, see Juxtacortical osteosarcoma localization microangiographic technique 74 mixed sclerotic-osteolytic type 68 multifocal 84 osteoblastoma versus 49, 52, osteolytic type 68 pathology 66, peripheral, see Peripheral osteosarcoma postradiation 409 prognosis 80 radiographic feature recurrence 94 sclerotic type 68, 80, 82 symptoms 66 synchronous versus metachronous 84 as systemic disease 88 telangiectatic variety 75, 80 types 80 Paget's disease fibrosarcoma, secondary 343 giant-cell tumor as complication of malignant transformation 75; see also Paget's sarcoma Paget's sarcoma incidence 401 pathologic features 405, 412 prognosis 405, 409 radiologic features 405 site symptoms 403 table of 402 treatment 405, 409 types of, table of 402 Pain 47 Paraffin-block method 5, 15 Parosteal lipomas 339, 341 Parosteal osteoma, see Juxtacortical osteoma PAS stain 16 Pathogenesis, see also Etiology adamantinoma aneurysmal bone cysts 436, 441 chondroblastoma chondromyxoid fibroma 158 cystic angiomatosis 3 17 Ewing's sarcoma giant-cell tumor juxta-articular bone cysts 444, 446, 448 metaphyseal fibrous defects 455, 462 osteochondroma 132 solitary bone cyst 424 Pathologic features 304 adamantinoma 385, 389 aneurysmal bone cysts 431, 433, 436 chondroblastoma 137, chondroma multiple 121 chondromyxoid fibroma chondrosarcoma chordoma 379, 382 clear-cell sarcoma 559 desmoplastic fibroma 335, 339 diffuse articular lipomatosis 546 eosinophilic granuloma 470, epidermoid cysts 507 Ewing's sarcoma 246, 252, fibrosarcoma 345, 354, 360 fibrous dysplasia 486, 488 fibrous histiocytoma, malignant 370 giant-cell tumor 217,220,224 hemangioma 304, 309, 546 hemangioendothelioma ,325 juxta-articular bone cysts juxtacortical chondroma. 117 lipoma 339, 341 massive osteolysis 317 mesenchymal chondrosarcoma metaphyseal fibrous defect 453, 455 myeloma myositis ossificans neurilemmoma

12 578 Pathologic features {cont.} nodular synovitis, localized 521, 526 osteochondroma osteoid osteoma 41, 47 osteosarcoma 66, Paget's sarcoma 403, 405 reticulosarcoma solitary bone cyst synovial chondromatosis 541 Periodic acid-schiff (PAS) 16 Periosteal chondroma 110 Periosteal chondrosarcoma 179 Periosteal circumscribed osteoblastoma 29 Periosteal desmoid 453 Periosteal hemangioma 304 Periosteal osteoblastoma, see Peripheral osteoblastoma Periosteal osteosarcoma Periosteal reaction 68 Peripheral chondrosarcoma 179, 186 Peripheral (periosteal) osteoblastoma 52 Peripheral osteosarcoma 84-95, 197 age juxtacortica1 chondrosarcoma versus 86, 99 metastasis pathogenesis periosteal versus 86 prognosis secondary terminology 95 treatment Perithelioma 246 Phantom bone 317 Phosphatase activity, alkaline 66, 83 Pigmented villonodular synovitis 448, 519, Plasma-cell granuloma 297 Plasma cells 291, 293 Plasmacytic growths, classification 281 Plasmacytic myelomatosis 281 Plasmacytoma Pleomorphism, cellular 74 Polyhistioma 80, 194 Polyostotic fibrous dysplasia 481, 486 Postradiation malignant transformation 229, 232, aneurysmal bone cysts 441 diagnosis, criteria for 409 fibrous dysplasia 490 prognosis 413 treatment 413 types of 409 Preexisting bone lesions ; see also Postradiation sarcoma aneurysmal bone cysts 436, 441 Paget's,disease, see Paget's sarcoma Primitive multipotential primary sarcoma 80, 316, 364 Prognosis adamantinoma alkaline phosphatase activity 66 aneurysmal bone cysts 44 1 angiosarcoma 329 chondroblastoma 148 Index chondroma 113, 115 multiple 121 chondromyxoid fibroma chondrosarcoma chordoma 384 clear-cell sarcoma 559 eosinophilic granuloma 480 Ewing's sarcoma , 267 fibrosarcoma 360 fibrous histiocytoma, malignant 370, 373 giant-cell tumor 220 grading 229, 360 hemangioendothelioma 325 hemangiopericytoma 327 juxta-articular bone cysts 451 juxtacortical chondrosarcoma 179, 186 juxtacortical osteosarcoma 95, liposarcoma 360 mesenchymal chondrosarcoma 194 metaphyseal fibrous defect 462 multifocal osteosarcoma 84 myeloma myositis ossificans 498 osteoblastoma, malignant osteochondroma 132 multiple 133 osteosarcoma 80 Paget's sarcoma 405, 409 peripheral osteosarcoma postradiation sarcoma 413 reticulosarcoma 277 solitary bone cysts synovial chondromatosis 541, 545 synovial sarcoma 553, 559 tumor size 90 xanthomatous areas 229 Progression, term 195 Pseudo-malignant osseous tumor of soft tissue Pseudotumorallesion, see Tumorlike lesions Pulmonary metastases chondroblastoma 148 peripheral osteosarcoma 88, 90, 93 Puncture biopsy, see Aspiration biopsy Race 1,401 Radiation biopsy and prior 4 etiology of tumors 85; see also Postradiation malignant transformation external 409 internal 409 ionizing 2, 409 Radiation therapy see also Postradiation malignant transformation aneurysmal bone cysts 44 1 chondroblastoma 148 chondrosarcoma 177 eosinophilic granuloma 480 Ewing's sarcoma 264, 267 fibrosarcoma 360 hemangioma

13 Index juxtacortical osteosarcoma 10 1 osteochondroma 132 peripheral osteosarcoma 89 reticulosarcoma 277 Radioactive sulfur 177 Radiologic features adamantinoma 385 aneurysmal bone cyst angiography 3 body-seerion 3 brown tumor of hyperparathyroidism 500 chondroblastoma 137 chondroma multiple chondromyxoid fibroma chondrosarcoma, primary chordoma 379 clear-cell chondrosarcoma 195 computerized axial tomography 3 cystic angiomatosis 3 11 desmoplastic fibroma 335 in diagnosis 2-3 eosinophilic granuloma epidermoid cysts 507, 5 10 Ewing's sarcoma fibrosarcoma 345 fibrous histiocytoma, malignant giant-cell tumor hemangioendothelioma , 325 juxta-articular bone cysts juxtacortical chondroma 117 juxtacortical osteosarcoma lipoma 339 liposarcoma 360 mesenchymal chondrosarcoma mesenchymoma, malignant 362 metaphyseal fibrous defect myeloma myositis ossificans neurilemmoma osteoid osteoma 36, 41 osteochondroma osteosarcoma Paget's sarcoma 405 procedures 3 reticulosarcoma scintigraphy 3 solitary bone cyst synovial chondroma 548 synovial chondromatosis 532 synovial sarcoma Radionuclide imaging (scintigraphy/bone scanning) 3 Radionuclides, bone-seeking danger 409 etiology of tumors 86 Reactive bone formation, tumor bone formation versus 82 von Recklinghausen's disease 394, 488, 500 Recurrence chondroblastoma 148 chondromyxoid fibroma 159 chondtosarcoma clear-cell sarcoma 559 desmoplastic fibroma 339 giant-cell tumor 232, 237 juxta-articular bone cysts 45 1 localized nodular synovitis 526 osteoblastoma 56 osteochondroma 132 osteosarcoma 94 treatment 94 Renal formation 298 Resection specimens Reticuloendothelial system neoplasms, classification of 268 Reticuloendotheliosis 466 Reticulosarcoma ,252, bone marrow 243 clinical findings definition 267 diagnosis 272, 273, 275, 473 pathologic findings prognosis 277 radiographic features treatment 277 Reticulum-cell lymphosarcoma 243 Reticulum-cell sarcoma of bone, see Reticulosarcoma RNA virus, C-type Roentgen therapy, see Radiation therapy Round-cell osteosarcoma 263 Sarcoma multiple foci in Paget's disease, see Paget's sarcoma radiation-induced, see Postradiation malignant transformation undifferentiated 366 Schwannoma Scintigraphy (bone scanning) 3 Sclerosis, bone 285, 289 osteoid osteoma 41 Sclerotic myeloma 285, 289 Sclerotic osteosarcoma 68, 80, 82 Sex adamantinoma 385 aneurysmal bone cyst 427 chondroblastoma 136 chondroma 110 chondromyxoidfibroma 150 chondrosarcoma, primary 161 chordoma 376 desmoplastic fibroma 335 eosinophilic granuloma 467 epidermoid cysts 507 epithelioid sarcoma 559 Ewing's sarcoma fibrosarcoma 343 fibrous histiocytoma, malignant 366 giant-cell tumor hemangioma 303 juxta-articular bone cysts 442 juxtacortical chondroma 16 juxtacortical osteosarcoma massive osteolysis 317

14 580 Index Sex [cont.] metaphyseal fibrous defect 451 myeloma 281 neurilemmoma 391 osteoblastoma, genuine 47 osteochondroma 124 multiple 132 osteoid osteoma 36 osteosarcoma 65 Paget's sarcoma 401 peripheral osteosarcoma reticulosarcoma solitary bone cyst 419 synovial' sarcomas 551 Site, see Localization Size of nidus 36 Skip metastases 88, Small-cell osteosarcoma 80 Smear technique 5, 8 Soft-tissue tumors 261 Solitary bone cyst clinical findings 419 definition 419 incidence 419 pathogenesis 424 pathologic findings prognosis radiographic features treatment Specimens, methods of handling Spiculated periosteal reaction 68 Spindled histologic pattern 389 Spine, osteoid osteoma 36 Spongious osteoblastoma 35 Spur 68 Stature 65 Strontium 85 3 Subchondral bone cysts 442 Subchondral cysts of osteoarthritis 446, 448 Subungueal exostosis 124 Sulfur, radioactive 177 Surgical biopsy 3-5 Sympathicoblastoma 263 Symptoms adamantinoma 385 aneurysmal bone cyst chondroblastoma 137 chondromyxoid fibroma 151 chondrosarcoma, primary 163 chordoma 379 eosinophilic granuloma 468 epidermoid cysts 507 Ewing's sarcoma' 245 fibrosarcoma 345 fibrous histiocytoma, malignant 366 giant-cell tumor 216 glomus tumor 317, 319 hemangioma 303, 504 hemangioendothelioma juxta-articular bone cysts 442 juxtacortical osteosarcoma 96 lipoma 546 localized nodular synovitis metaphyseal fibrous defect 452 myeloma myositis ossificans 491 neurilemmoma 391 osteoblastoma, genuine osteochondroma osteoid osteoma 36, 47 osteosarcoma 66 Paget's sarcoma 403 reticulosarcoma 269 solitary bone cyst 419 synovial chondroma 548 synovial sarcoma 551 Synovial chondromatosis (osteochondromatosis) 519, 532, 545 Synovial chondrosarcoma 545 Synovial cyst , 446 Synovial membrane benign tumor of fibroma 548 hemangioma 546 lipoma 546 synovial chondroma 548 clear-cell sarcoma 559 diffuse articular lipomatosis epitheliod sarcoma 559, 561 localized nodular synovitis malignant pigmented villonodular synovitis synovial chondromatosis synovial sarcoma types of 520 Synovial sarcoma 519,527, Synovium, lining cell Systemic disease 88, 500 Telangiectatic osteosarcoma 75, 80 Terminology, see Classification; Definition Tomography (body section radiography) 3 Trabeculae 41,82 Transepiphysea1 spread 74 Trauma 88, 385, 389 myositis ossificans 490, synovial chondromatosis 532 Treatment adamantinoma aneurysmal bone cysts 44 1 chondroblastoma 135, 148 chondroma 113, 115 multiple 121 chondromyxoid fibroma chondrosarcoma chordoma 384 clear-cell chondrosarcoma 195 desmoplastic fibroma 339 diffuse articular lipomatosis 546 eosinophilic granuloma 480 Ewing's sarcoma , 267

15 Index 581 epidermoid cysts 507, 5 10 fibroma 548 fibrosarcoma 360 fibrous histiocytoma, malignant 370, 373 giant-cell tumor 232, 237 hemangioma 309 hemangioendothelioma 325 hemangiopericytoma 327 juxta-articular bone cysts 451 juxtacortical chondroma 117 juxtacortical osteosarcoma liposarcoma 360 localized nodular synovitis 526 mesenchymal chondrosarcoma 194 mesenchymoma, malignant 362 metaphyseal fibrous defect 462 myeloma 298 myositis ossificians 498 neurilemmoma 392 osteoblastoma, malignant 62 osteochondroma 132 multiple 133 Paget's sarcoma 405, 409 peripheral osteosarcoma postradiation sarcoma 413 recurrence 94 reticulosarcoma 277 solitary bone cysts synovial chondroma 548 synovial chondromatosis 54 1, 545 synovial sarcoma 553, 558 Trocar biopsy, see Aspiration biopsy Tubular histologic pattern 389 Tumor bone formation, reactive bone formation versus 82 Tumor size, ptognosis 90 Tumorlike lesions ; see also Aneurysmal bone cyst; Eosinophilic granuloma; Fibrous dysplasia; Juxta-articular bone cyst; Metaphyseal fibrous defect; Myositis ossificans; Solitary bone cyst; Synovial membrane brown tumor of hyperparathyroidism epidermoid cysts 507, 510 table of 21 Undifferentiated sarcoma 366 Unicameral bone cyst, see Solitary bone cyst Vascular lesions angiosarcoma 329 benign ; see also Hemangioma glomus tumor hemangioendothelioma, see Hemangioendothelioma hemangiopericytoma 327 lymphangioma 317 malignant ,329 WHO classification 319 Vinblastine sulfate 480 Virchow's hypothesis 132 Viruses Waldenstrom's macroglobulinemia 293 World Health Organization (WHO) classification system 18-19, 2 1 table 19 undifferentiated sarcoma 366 vascular tumors 319 definitions, see Definition Xanthomatous areas, prognostic value 229 Xanthomatous variant of giant-cell tumor 451