Factors regulating the metastatic potential of benign giant cell tumour of bone--study of an unusual case with short review of literature.

Benign giant cell tumour of bone with metastases to other bones and lungs is extremely rare. Benign metastasising giant cell tumour is distinctly separate from multicentric giant cell tumour, primary and secondary malignant giant cell tumour. Factors regulating the local recurrence and metastatic potential of this benign tumour depend on its aggressiveness which can be better assessed by clinical and radiological parameters rather than the histopathological appearance. A benign giant cell tumour of ischium with metastasis to vertebra and lung over an eleven year period is discussed. Extreme paucity of literature prompted to publish the article. A short review of factors determining the recurrence and metastatic spread of benign giant cell tumour of bone is highlighted.

Ewing's sarcoma of bone--a study of 71 cases by fine needle aspiration cytology.

Fine needle aspiration cytology (FNAC) plays immense diagnostic role in Ewing's sarcoma of bone. As clinically and sometimes radiologically Ewing's sarcoma mimics osteomyelitis of bone, FNAC is of great help to distinguish these 2 lesions and can avoid unnecessary incisional biopsies in most of the cases. At present limb salvage therapy is replaced by chemotherapy and radiotherapy. Moreover most of the patients present with gross soft tissue involvement where exact categorisation of malignant bone tumour is not possible by radiological means. FNAC is of great benefit to the clinicians and the patients as it provides a quick and accurate report and surgical interventions can be avoided in most of the cases. This paper highlights the cytological appearance of Ewing's sarcoma of bone in 71 cases. A conclusive diagnosis can be made with the help of special stains and cell block study. The diagnostic accuracy was 100% without any complication.

CT-guided needle aspiration cytology (FNAC) of 112 vertebral lesions.

Aspiration cytology under CT-guidance was utilised as a diagnostic device in 112 lesions of vertebrae from January, 1985 till August, 1992. The age of the patients ranged from 6 years to 82 years. The materials were spread on glass slides, air-dried and stained by May-Grunwald and Giemsa method. In few cases part of the aspirated material was utilised for special stain and cell block preparation. Analysis of results showed metastatic tumours in 61 cases, Tuberculous lesions in 24 cases, Plasmacytoma in 6 cases, Giant cell lesion in 6 cases, Eosinophilic Granuloma in 3 cases, Chordoma in 3 cases, Ewing's sarcoma in 2 cases, Hodgkin's disease in 2 cases, Chondrosarcoma in 1 case and no definite diagnosis was given in 4 cases. These 4 cases on exploration and biopsy proved to be osteoblastoma (2), haemangioma (1) and undifferentiated sarcoma in the other. The giant cell lesions on histopathology proved to be aneuryamal bone cysts in 4 cases while osteoclastoma in 2 cases. The diagnostic accuracy was 96.4%. No complication was encountered in the present study. Early diagnosis by needle aspiration cytology (NAC) prevented unnecessary surgical exploration in majority of the cases and treatment could be started at the earliest.

Septum and adrenocortical function.

Dorsal septum is an intermediary centre in between the hippocampus and hypothalamus and it has got inhibitory influence over the hypothalamo-pituitary-adrenal axis. Stimulation of the dorsal septum manifested with fall in adrenocortical output whereas its lesion has opposite response. Ventral septum is a facilitatory area regarding activation of the hypothalamo-pituitary-adrenal axis. It is a balancing centre lying in between the higher central nervous system structures and the hypothalamus. Stimulation and lesion of the ventral septum led to rise and fall in adrenal venous 17-OHCS output respectively. Adrenocortical response to stress of burn was not blocked or inhibited following lesion of the dorsal as well as ventall septum.