Thread by @DrRolaAli

🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪
🍪🍪🍪🍪Giant Cells🍪🍪🍪🍪
🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪🍪

Part1️⃣

1/6
What better way to kick-start the new year🎇than with a tweetorial/#RolaCoaster ?
Specifically made for the #pathtwitter family💝
Hope you enjoy the🎢!

#BSTPath @kells108 @natasharekhtman

2/6

Qs:
Can you tell these 2 giant-cell rich lesions apart❓🧐

Answer is coming in Part2️⃣ of this #Tweetorial

#BSTPath @kriyer68 @Histopatolomon @HENRYY_MD @ADamronMD @D4L14H @AlanPath @padmapathology1 @DrMarkOng @MBBS_Pathology
@Chucktowndoc @RunjanChetty @pembeoltulu

3/6

So…
▪️Why is this distinction difficult❓🤔
Because...
- Location is unknown
- Architecture not appreciated
- Age unknown

▪️Solution❓
- Radiology is 🔑
(closest thing to gross
specimen is the black/
white ‘negative’ image!)

4/6

Regarding location, ask yourself:
☠️What bone❓
- Long e.g. femur
- Flat e.g. rib
- Small tubular e.g. phalanx

☠️If long🦴, which part❓
- Epiphysis
- Metaphysis
- Diaphysis

☠️Where in relation to cortex/medulla❓
- Intramedullary
- Intracortical
- Surface

5/6

Role of the osteoclastic giant cells:

🍪Non-neoplastic bystanders
🍪The sneaky guys are actually the mononuclear stromal cells which secrete cytokines & other factors
🍪These paracrine signals induce osteoclast proliferation and activation
🍪Net result: bone resorption

6/6

Case:
Gross specimen of an osteolytic tibial lesion in an adult👇🏻

Based on epiphyseal location alone, what are the 3 top differentials❓

Stay tuned for Part2️⃣❗️