Question:hard
A red soft to firm swelling on the sternum, biopsied with the histology shown above. What is the diagnosis?
A red soft to firm swelling on the sternum, biopsied with the histology shown above. What is the diagnosis?
Show Hint
A red bony swelling with vascular channels on histology.
Updated On: Jun 24, 2026
- Hemangioma
- Osteochondroma
- Osteoid osteoma
- Paget disease
Show Solution
The Correct Option is A
Solution and Explanation
Step 1: Use color as the signpost. A red lesion over bone implies abundant blood vessels, which immediately narrows the list toward a vascular tumor rather than a cartilaginous or sclerotic one.
Step 2: Confirm with pathology. A primary intraosseous hemangioma is a benign, slow growing tumor sitting in the medullary cavity. Under the microscope it is hamartomatous vascular tissue with endothelial-lined channels, sometimes containing fat, smooth muscle, fibrous stroma and thrombi. Although benign, it can rarely behave locally aggressively or fracture when large.
Step 3: Eliminate alternatives. Osteochondroma carries a hyaline cartilage cap over a bony stalk. Osteoid osteoma is a tiny nidus-bearing lesion famous for nocturnal pain easing with aspirin. Paget disease produces thickened, mosaic-patterned bone on biopsy. None give red vascular channels.
The vascular swelling matched to vascular histology yields a single answer.\[\boxed{\text{Hemangioma}}\]
Step 2: Confirm with pathology. A primary intraosseous hemangioma is a benign, slow growing tumor sitting in the medullary cavity. Under the microscope it is hamartomatous vascular tissue with endothelial-lined channels, sometimes containing fat, smooth muscle, fibrous stroma and thrombi. Although benign, it can rarely behave locally aggressively or fracture when large.
Step 3: Eliminate alternatives. Osteochondroma carries a hyaline cartilage cap over a bony stalk. Osteoid osteoma is a tiny nidus-bearing lesion famous for nocturnal pain easing with aspirin. Paget disease produces thickened, mosaic-patterned bone on biopsy. None give red vascular channels.
The vascular swelling matched to vascular histology yields a single answer.\[\boxed{\text{Hemangioma}}\]
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