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Patologi Anatomi Musculosceletal
Patologi Anatomi Musculosceletal
dr. Sahrun
I DISEASES OF BONE
1. CONGENITAL & HEREDITARY DS OF BONE
2. OSTEOPOROSIS & ACQUIRED METABOLIC DS
3. OSTEOMYELITIS
4. PAGET DS (OSTEITIS DEFORMANS)
5. BONE TUMORS
I DISEASES OF BONE
1. Congenital & Hereditary Diseases of Bone
- Congenital ds (structural lesions) :aplasia, extra
bones, abnormal fusion of bones
a. Achondroplasia
- AD, impaired maturation of cartilage in developing
growth plate
- cartilaginous g.p : hypoplastic / disorganized
aggregates of chondrocytes
b. Osteogenesis Imperfecta/Brittle bone disease
- AD,AR, abnormal development of type I collagen
- multiple bone fracture,hearing loss,blue sclera
Fig 21-2
Scanning electron micrograph of a normal bone (A) and a bone with osteoporosis (B)
3. Osteomyelitis
- inflammation of the bone & marrow cavity by
infectious agents, acute/ chronic
a.Pyogenic osteomyelitis
- morphology :
acute : neutrophilic, necrotic
chronic :chronic
inflamm.cell,repair(osteoclast,fibro
blast,new bone),sequestrum(residual necrotic
bone)
involucrum(large sequestra, rim reactive bone)
b.Tuberculous Osteomyelitis
Fig 21-5 Paget disease, mosaic lines between areas of new bone formation
5.Bone Tumors
a.Bone - Forming Tumors
a.1 Osteoma
- hard,exophytic
- micros : bland mixture woven & lamellar
bone
a.2 Osteoid Osteoma & Osteoblastoma
- morphology: nidus, trabeculae woven bone,
osteoblast, loose vascular connective
tissue, giant cells
b. Cartilaginous Tumors
b.1 Osteochondroma (exostoses)
- mature bone & a cartilaginous cap
b.2 Chondroma ( Enchondroma)
- mature hyaline cartilage, within medullary
cavity
b.3 Chondrosarcoma
- morphology : medullary cav, glistening
mass
erodes the cortex, well-diff (minimal
cytologic
atypia)-poorly diff ( highly pleomorphic
chondrocytes),multinucleate cell, 2/>
cell/lacuna
2. Gout
- tissue accumulation of excessive amounts of
uric acid
& end product of purine metabolism
Morphology :
acute arthritis: deposition monosodium urate
crystal
in synovial tissue,neutrophilic infiltrate, local
congestion & edema
chronic tophaceous arthritis :
- tophus
Gouty nephropathy
3. Infectious Arthritis
a. Acute Suppurative Arthritis
- most : bacteria( Go,Staph,Strep, H.influenzae)
b. Lyme Disease
- spirochete Borrelia burgdorferi, rodent, deer
tick
- multiple organ systems, 3 stage : ( figure 2119)
2.Myasthenia Gravis
- acquired autoimmune disorder of
neuromuscular
transmission
- 90% AB to acetylcholine receptor
- clinic: muscle weakness,latter part of the day,
slowly progressive
3. Inflammatory Myopathies
- Trichinosis :
ingestion inadequately cooked meat ( >
pork)
Trichinella spiralis cyst duodenum/jejunum
wall
bloodstream different site
skeletal muscle : inflammatory reaction
4. Muscular Dystrophies
Duchenne and Becker Muscular Dystrophy
- DMD : X-linked, absence of dystrophin
- BMD : X-linked, mutation in dystrophin gene,
abnormal form of dystrophin, less severe
- morphology :
marked variation in muscle fiber size
(concomitant
hypertrophy & atrophy myofibers)
degenerative changes (splitting & necrosis)
regeneration(sarcoplasmic basophilia, nuclear
enlargement, nucleolar prominence)
connective tissue throughout the muscle
3. Fibrohistiocytic Tumors
a.Fibrous Histiocytoma (BFH)
b.Dermatofibrosarcoma Protuberans
- Intermediate
c. Malignant Fibrous Histiocytoma
Fig 21 (WHO)