Quantitative ELISA-Like Immunohistochemistry of Fibroblast Growth Factor 23 in Diagnosis of Tumor-Induced Osteomalacia and Clinical Characteristics of the Disease

Figure 2

Representative hematoxylin and eosin staining of the PMTMCTs. (a) Infiltrative growth and destructive manner of the tumor. Black arrowhead indicates the destruction of bone trabeculae. White arrowhead indicates that a large number of osteoclast-like giant cells are scattered in the area of bone destruction. (b) Abundant blood vessels with “staghorn” appearance are presented. Black arrowhead indicates the “staghorn” vessels. White arrowhead indicates the cartilage formation. (c) Tumor cells are arranged around the capillaries. Black arrowhead indicates the nested arrangement of tumor cells. White arrowhead indicates the peripheral woven bone shell. (d) Osteoclast-like giant cells are scattered particularly where there is abundant hemorrhage. Black arrowhead indicates the osteoclast-like giant cells. White arrowhead indicates the chondroid matrix. (e) Fat cells, calcifications, and hemosiderin pigmentation could be found in most cases. Black arrowhead indicates the fat cells. White arrowhead indicates the calcifications. (f) The tumor cells and osteoid formation are shown. The tumor cells are usually small, oval-spindle shaped without atypia and embedded in a distinctive matrix. Black arrowhead indicates the oval shaped tumor cells. White arrowhead indicates the osteoid.

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