Summary
A 13-year-old boy affected by bursitis of the R knee and nonossifying fibroma of the distal metaphysis of the R femur, was treated in the weeks prior to surgical intervention with water-soluble aspirin tablets to relieve local pain. Unexpected epithelioid cell granulomata were observed inside the neoplastic fibrous stroma of the nonossifying fibroma.
The coincidental appearance of a slight blood eosinophilia (7%) and perioral fixed drug eruption are clues that suggest that the histological bone findings may represent an expression of the hypersensitivity response elicited by aspirin. It cannot be ruled out that this unusual finding may be related to documented previous trauma, resulting in interstitial hemorrhages and subsequent reactive resorptive processes.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Ackerman AB (1978) Histologic diagnosis of inflammatory skin diseases. Lea & Febiger, Philadelphia
Adams DO (1976) The granulomatous inflammatory response. A review. Am J Pathol 84:164–191
Aegerter E, Kirkpatrick JA (1968) Orthopedic diseases. Physiology, Pathology, Radiology. W.B. Saunders Company, Philadelphia
Churg J, Strauss L (1951) Allergic granulomatosis, allergic angiitis, and periarteritis nodosa. Am J Pathol 27:277–301
Dehner L (1975) Pediatric surgical pathology. C.V. Mosby Company, St Louis
Goldgraber MB, Kirsner JB (1958) Granulomatous lesions — an expression of a hypersensitive state. An experimental study. Arch Pathol 66:618–634
Hamilton PK (1954) The bone marrow in brucellosis. Am J Clin Pathol 24:580–587
Hovde RF, Sundberg RD (1950) Granulomatous lesions in the bone marrow in infectuous mononucleosis. A comparison in the changes in the bone marrow in infectuous mononucleosis with those of brucellosis, tuberculosis, sarcoidosis, and lymphatic leukemia. Blood 5:209–232
Huvos GA (1979) Bone tumors. Diagnosis, treatment and prognosis. W.B. Saunders Company, Philadelphia
Irey NS (1976) Tissue reactions to drugs. Am J Pathol 82:617–647
Jaffe HL (1958) Tumors and tumorous conditions of the bones and Joints. Lea & Febiger, Philadelphia
Lever WF (1967) Histopathology of the skin. 4th Edn. J.B. Lippincott, Philadelphia
McMaster KR, Ennigar GR (1981) Drug-induced granulomatous hepatitis. Lab Invest 44:61–73
Mirra JM (1980) Bone tumors. Diagnosis and treatment. J.B. Lippincott Company, Philadelphia
Nezelof C, Wilde F (1986) Les aspects immunologiques des granulomes inflammatoires. Arch Anat Cytol Pathol 24:431–457
Nugent FW, Glaser D, Fernandez-Herliby (1976) Crohn's colitis associated with granulomatous bone disease. N Engl J Med 294:262–263
Okum DB, Sun NCJ, Tanaka KR (1979) Bone marrow granulomas in Q fever. Am J Clin Pathol 71:117–121
Pease GL (1956) Granulomatous lesions in bone marrow. Blood 11:720–734
Samster M, Zeitz HJ (1978) The aspirin triad and the prostaglandins. In: Samter M (ed) Immunological diseases. Little Brown and Company, Inc, New York, pp 900–916
Spjut H, Dorfman HD, Fechner RE (1971) Tumors of the bone and cartilage. Atlas of tumor pathology. Armed Forces Institute of Pathology, Washington
Unanue ER: The immune granulomas (1978) In: Samter M (ed) Immunological diseases. Little Brown and Company, Inc, New York, pp 297–306
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cozzutto, C., Comelli, A. Epithelioid granulomata in a nonossifying fibroma. Virchows Arch. A Path. Anat. and Histol. 397, 61–66 (1982). https://doi.org/10.1007/BF00430893
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00430893