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Bone Neoplasia in the 21st Century - Using Fibrous Dysplasia as the Model for How Far We’ve Come
Diagnostic bone pathology can be challenging for even the most seasoned surgical pathologist. Concerns about overlooking or under-diagnosing of a bone tumor often arise because of histologic similarities between reactive lesions and neoplastic processes and with the realization that bone has only a limited number of ways to respond. This presentation focuses on fibrous dysplasia, one of the most common of all bone tumors-but one which is often diagnostically challenging to pathologists. Although the emphasis is on clinical, radiologic and morphologic features useful in the creation of a differential diagnosis regarding fibrous dysplasia, supplemental techniques are discussed. Similarly, common traps to avoid are reviewed in the context of the cases. Rare variants and unusual presentations of common entities are covered in the discussion. Where appropriate, diagnoses verified or supported by molecular diagnostics, flow cytometry, immunohistochemistry, and electron microscopy are described and illustrative examples demonstrated.
Originally presented September 26, 2013 in Salt Lake City, Utah.
Gene P. Siegal, MD, PhD
R. W. Mowry Endowed Professor of Pathology, University of Alabama at Birmingham
Executive-Vice Chair of Pathology, University of Alabama at Birmingham
Gene P. Siegal, MD, PhD, the R. W. Mowry Endowed Professor of Pathology and Executive-Vice Chair of Pathology at the University of Alabama at Birmingham, is an experimental and diagnostic musculoskeletal pathologist. He is the P. I. of the Histomorphometry and Molecular Analysis Core in the Center for Metabolic Bone Disease at UAB. He has in excess of 700 peer-reviewed manuscripts, book chapters, abstracts and other professional writings, currently serves on 19 editorial boards and is one of the Section Editors for Bone & Soft Tissue for CAP’s Archives of Pathology and the Editor-in-Chief of Laboratory Investigation. Recent books of his include several on bone including the AFIP Fascicle on Non-Neoplastic Bone Diseases for which Dr. Klein was the principal author. He also is one of three editors for the CAP Press monograph on Laboratory Administration for Pathologists.
After this presentation, participants will be able to:
- Understand the epidemiology, radiology and pathology that underpins the making of the correct diagnosis of fibrous dysplasia.
- Recognize the molecular mechanisms thought to be responsible for the etiology of fibrous dysplasia.
- Become familiar with the biologic spectrum of fibrous dysplasia including malignant transformation and associated sequelae.
University of Utah School of Medicine, University of Utah Department of Pathology, and ARUP Laboratories