Xanthogranulomatous osteomyelitis of ulna mimicking neoplasm
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Case report
Xanthogranulomatous osteomyelitis of ulna mimicking neoplasm Mahesha Vankalakunti1, Uma N Saikia*1, Manoj Mathew2 and Mandeep Kang3 Address: 1Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India, 2Department of Orthopedic surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India and 3Department of Radiodiagnosis Postgraduate Institute of Medical Education and Research, Chandigarh, India Email: Mahesha Vankalakunti - [email protected]; Uma N Saikia* - [email protected]; Manoj Mathew - [email protected]; Mandeep Kang - [email protected] * Corresponding author
Published: 30 April 2007 World Journal of Surgical Oncology 2007, 5:46
doi:10.1186/1477-7819-5-46
Received: 21 December 2006 Accepted: 30 April 2007
This article is available from: http://www.wjso.com/content/5/1/46 © 2007 Vankalakunti et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Xanthogranulomatous osteomyelitis often presents as a severe chronic inflammation associated with pain, fever, and leukocytosis. It may mimic carcinoma in the involved organs. Case presentation: A 50-year-old post-menopausal woman presented with a 2 year history of increasing swelling in the extensor aspect of her right forearm. Plain X-ray revealed an ill-defined expansile osteolytic lesion in the diaphysis of ulna. The gross, microscopic and ultrastructure findings of the curettage specimen was consistent with xanthogranulomatous osteomyelitis. Conclusion: This case highlights the rare occurrence of xanthogranulomatous osteomyelitis involving ulna, which can mimic as a primary or secondary bone tumors. A correct diagnosis can only be made on histopathological examination.
Background Xanthogranulomatous osteomyelitis (XO) is a specific type of chronic inflammatory process characterized by collection of foamy macrophages admixed with mononuclear cells [1]. On gross examination, this phenomenon can mimic carcinoma in the involved organs [2]. XO has characteristic findings, i.e., the presence of granular, eosinophilic, PAS positive histiocytes in the initial stages; the mixture of foamy macrophages and activated plasma cells; the presence of suppurative foci and hemorrhage. It has been encountered in various tissues viz. the gallbladder, kidney, urinary bladder, fallopian tube, ovary, vagina, prostate, testis, epididymis, colon and appendix. Very rarely, it can affect lungs, brain, or bone. Only two cases
of xanthogranulomatous osteomyelitis described previously in the literature [3].
have
been
Case presentation A 50-year-old post-menopausal woman presented to the out-patient department with a bony hard swelling on the extensor aspect of her right forearm. The swelling was gradua
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