Bone and Soft Tissue Pathology Discovered in Bone Bank Donors: An Analysis of 109 Lesions
Stefania S Giobbe, Benjamin L Hoch. University of Washington, Seattle, WA
Background: Bone is the second most frequently transplanted human tissue with bone allografts being used in orthopaedics. Bone banking generally focuses on eliminating risk of infection and selecting bone with structural integrity. Screening procedures aim to exclude donors at risk of transmitting a malignant neoplasm. However, bone and soft tissue lesions are still identified during the procurement process. The incidence and significance of such lesions is uncertain. We analyze a large series of bone and soft tissue lesions sent for pathologic examination by a large regional tissue bank.
Design: We examined bone and soft tissue cases from anonymous post mortem donors submitted for review by a regional tissue bank from 2002-2011. The selected tissue was deemed abnormal by the tissue bank based on visual inspection or roentgenographic examination. Gross and microscopic examination was performed by an experience bone and soft tissue pathologist to ascertain the viability and safety of the donor's unaffected skeletal tissues. All H&E slides were re-reviewed for this study.
Results: 109 lesions were identified in 89 donor patients. 71% of donors were male and 29 female. Most commonly affected bones in descending order included femur, tibia, patella, humerus, fibula, costal cartilage, and ilium. Bone lesions included bone infarct (16), osteopenia (12), traction exostosis (8), bone island (5), enchondroma (5), intraosseous ganglion cyst (1), osteochondroma (3), non-ossifying fibroma (2), hemangioma (1), solid ABC (2), subchondral cyst (1), subchondral fracture (1), and osteocartilaginous loose body (1), non-specific remodeling (4), reactive/degenerative changes of bone and cartilage (3). The most common soft tissue sites included Achilles tendon, patellar tendon and soft tissue around the knee. Soft tissue lesions included tendon with degenerative changes (12), synovial cyst (4), ganglion cyst (4), lipoma (2), metaplastic bone (2), tenosynovial giant cell tumor (1), gout (1) and calcific tendinosis (1). 16 lesions identified by the bone bank had no pathological abnormality identified.
Conclusions: Bone and soft tissue lesions discovered during bone banking procurement procedures are uncommon and invariably benign. Bone infarct and osteopenia were the most common bone lesions discovered. The most common soft tissue lesion was degenerative changes of tendons and ganglion and synovial cysts. The most common bone tumors were enchondroma and osteochondroma. Unaffected donor bone can be utilized in the vast majority of cases. However, cases of osteopenia raise concern for the quality of bone procured.
Category: Bone & Soft Tissue
Tuesday, March 20, 2012 9:30 AM
Poster Session III # 11, Tuesday Morning