PMC3529877_01
(a) X-ray and (b) CT scan-lobulated, expansile, intramedullary lesion (arrow) with ground-glass centre and thinning of the cortex arising from the anterolateral aspect of the left 5th rib.
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fig1
Radiologically, X-ray and computed tomography (CT) scan showed lobulated, expansile intramedullary lesion with a ground-glass centre and thinning of the cortex arising from the anterolateral aspect of left the 5th rib (Figures 1(a) and 1(b)).
Gross: firm, well defined solid grey white expansile mass replacing the medullary cavity of the rib (arrow) with areas of hemorrhage.
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fig2
The mass was surrounded by thin bony cortex that has not invaded the surrounding structures (Figure 2).
The specimen X-ray ((a) and (b)) displaying the intact lesion with no soft tissue extension.
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fig3
The specimen X-ray confirmed intact of the lesion and no soft tissue extension (Figures 3(a) and 3(b)).
Microscopy, (a) "Chinese alphabet" spicules of woven bone (arrows) separated by abundant fibrous stroma (H&E, 20x). (b) No atypia of stromal cells (H&E, 100x).
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fig4
The osseous component consists of disorganized irregular "Chinese alphabet" spicules of woven bone separated by abundant fibrous stroma (Figure 4(a)). The fibrous component is composed of cytologically bland spindle cells with no atypia of stromal cells (Figure 4(b)).
Microscopy, (a) FD (left) With ABC (right) changes:hemorrhagic spaces lined by osteoclast-like multinucleated giant cells (arrows) (H&E, 20x). (b) Osteoclast-like multinucleated giant cells lining hemorrhagic spaces (arrows) (H&E, 100x). (c) Intact periosteum with host lamellar bone and no soft tissue extension (H&E, 20x).
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fig5
Hemorrhagic spaces lined by osteoclast-like multinucleated giant cells of ABC changes were seen (Figures 5(a) and 5(b)). Intact periosteum with host lamellar bone and no soft tissue extension was noted (Figure 5(c)).