Qap (Anatomical Pathology) 

QAP Peer Review

AP341
Case History: M/11. Right 4th metatarsal bone pathological fracture.
Intended diagnosis: Osteoblastoma-like osteosarcoma, grade 2/4. Contributed by:MST
Code Diagnosis Comment Score
anonymous Bizarre parosteal osteochondromatous proliferation (100 %) nil  20
anonymous Osteosarcoma nil  100
anonymous OSTEOSARCOMA check with X-ray  100
anonymous Osteosarcoma 100% Immunohistochemical studies for SATB2 (positive). Also S100 to rule out chrondroblastoma.  100
anonymous Osteoblastoma-like osteosarcoma, grade 2 out of 4. To confirm by FISH for MDM2 and CDK4 amplification. To correlate with clinical and radiological findings.  100
anonymous Osteoblastoma-like osteosarcoma nil  100
anonymous Metatarsal bone - Osteosarcoma 95% - Aggressive osteoblastoma 5% Radiological features have to be correlated  100
anonymous Suspicious bone forming tumour, correlate with radiological features Correlate with radiological features  80
anonymous Osteosarcoma nil  100
anonymous Favor Osteosarcoma. nil  100
anonymous Right metatarsal BONE lesion:- OSTEOSARCOMA Please correlate with clinical and imaging findings.  100
anonymous Osteoblastoma-like osteosarcoma. nil  100
anonymous Atypical osteoblastic lesion, favour osteoblastoma (80%), differential diagnosis of osteosarcoma (20%) to be excluded by clinical/radiological correlation and further sampling. Correlation with the radiological findings and other histologic sections are essential to arrive at a definitive diagnosis. The X-ray appearance of the lesion (such as borders and periosteal reaction) should be assessed to see whether its features favour a benign or malignant lesion. Additional histologic sections also need to be sampled to look for areas of definite high grade cytologic atypia or atypical mitoses, which would favour osteosarcoma if present.  70
anonymous osteosarcoma (100%) correlate with radiologic findings  100
anonymous Suspicious of osteosarcoma, important differential diagnosis is aggressive osteoblastoma, need to correlate with radiological findings (100% Probability). nil  80
anonymous Osteoblastoma nil  50
anonymous Chondroblastoma (50%) DDX: Bizarre parosteal osteochondromatous proliferation (50%) nil  20
anonymous Right 4th metatarsal bone - Differential diagnoses include osteosarcoma (70%) and aggressive osteoblastoma (30%). Correlation with clinical and radiological findings is essential.  100