Degenerative disc disease
| Degenerative disc disease | |
|---|---|
| Diagnosis in short | |
 Degenerative disc disease. HPS stain. | |
|
| |
| LM | benign fibrous tissue, nests of chondrocytes |
| LM DDx | chondrocalcinosis, synovial cyst, malignancy (primary or metastasis) |
| Site | vertebral disc - see spine |
|
| |
| Symptoms | back pain |
| Prevalence | common |
| Radiology | disc herniation |
| Prognosis | benign |
| Treatment | surgical (e.g. discectomy) |
Degenerative disc disease, abbreviated DDD, is a common ditzel, typically generated in the course of a discectomy operation.
Vertebral disc and discectomy redirect here.
General
- Herniated disc - causes back pain.
- May result in cauda equina syndrome.
- Composed of fibrous cartilage.[1]
Microscopic
Features:
- Benign fibrous tissue.
- Nests of chondrocytes (as in immature cartilage).
- +/-Synovium with or without proliferation.[2]
- +/-Neovascularization of disc material.[2]
- Hemosiderin deposits (trauma or previous surgery).
DDx:
- Chondrocalcinosis (CPPD).[2]
- Synovial cyst.
- Malignancy - very rare if not suspected.
Images
Degenerative disc disease - intermed. mag. (WC)
Degenerative disc disease - high mag. (WC)
DDD - intermed. mag. (WC)
DDD - high mag. (WC)
DDD - very high mag. (WC)
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Disc Material (Left L5-S1 Disc), Excision: - Consistent with disc material (gross only).
Note:
- May be gross only specimens; a minority of institutions handle these specimens this way.[5]
- It is suggested that gross only specimens should have no history or suspicion of malignancy - based on the surgical note, available pathology and imaging.
Block letters
CERVICAL DISC, DISCECTOMY: - DISC WITH DEGENERATIVE CHANGES. - NO EVIDENCE OF MALIGNANCY.
LUMBAR DISC, DECOMPRESSION: - DEGENERATIVE DISC DISEASE.
See also
References
- ↑ URL: http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm. Accessed on: 2 January 2010.
- ↑ 2.0 2.1 2.2 2.3 Pytel, P.; Wollmann, RL.; Fessler, RG.; Krausz, TN.; Montag, AG. (Feb 2006). "Degenerative spine disease : pathologic findings in 985 surgical specimens.". Am J Clin Pathol 125 (2): 193-202. doi:10.1309/89FV-RT04-EGBV-EUD9. PMID 16393686.
- ↑ Hasselblatt, M.; Maintz, D.; Goll, T.; Wildförster, U.; Schul, C.; Paulus, W. (Jan 2006). "Frequency of unexpected and important histopathological findings in routine intervertebral disc surgery.". J Neurosurg Spine 4 (1): 20-3. doi:10.3171/spi.2006.4.1.20. PMID 16506461.
- ↑ Modic, MT.; Ross, JS. (Oct 2007). "Lumbar degenerative disk disease.". Radiology 245 (1): 43-61. doi:10.1148/radiol.2451051706. PMID 17885180.
- ↑ Zarbo, RJ.; Nakhleh, RE. (Feb 1999). "Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions.". Arch Pathol Lab Med 123 (2): 133-9. doi:10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2. PMID 10050786.