Mild pressure of the swelling of GCT is supposed to produce a characteristic egg shell crackling, which of the following statements regarding this exclusive clinical feature is correct. (AIPG 2009)
|A||This finding is seen at all stages of GCT|
|B||It is seen only in the early stages|
|C||It is a finding seen only GCT upper end of fibula|
|D||This finding is noted in the later stage of GCT|
This finding is noted in the later stage of GCT
a. A giant cell tumor is hardly ever seen before closure of the epiphysis in that region and characteristically extends upto the subarticular bone it is never seen in the diaphysis.
b. Radiographs characteristically show a large sharply circumscribed area of reduced density asymmetrically located in the epiphysis beginning subcortically and extending upto the metaphysis.
c. The cortex is expanded outward and thinned.
d. No periosteal new bone is apparent multiple septae of bone and soft tissue traverse the interior and produce a 'soap bubble' appearance.
e. The characteristic feature of a GCT under the microscope is the presence of an abundance of tumor giant cells.
f. These large cells measure from 10 to 100 and contain many centrally placed uniformly sized nuclei.
g. The number of nuclei varies from 15 upward, sometimes estimates being as high as 150, the giant cells are numerous about areas of hemorrhage, spicules of old bone and walls by comparison the Langhans giant cells contain a small number of peripherally placed nuclein the foreign body sized centrally placed nuclei, of small cysts.
h. The foreign body giant cell is smaller containing less than 15 nuclei which are various sized and place centrally. Egg shell crackling is seen In the later stages of tumor evolvement when the cortex is sufficiently eroded to become thin enough to crack on pressure.