10: Pathology - malignant tumours

Question 1

How are MSK tumours discovered?

Answer 1

Examination

Radiology

Question 2

Sarcomas are (more / less) common than carcinomas.

Answer 2

less common

Question 3

What is a lipo(sarco)ma?

Answer 3

Tumour of adipose tissue

Question 4

What is a leio(sarco)ma?

Answer 4

Tumour of smooth muscle

Question 5

What is a rhabdomyo(sarco)ma?

Answer 5

Tumour of skeletal muscle

Question 6

How are MSK tumours staged and identified?

Answer 6

Biopsy

Question 7

Primary MSK tumours often have a ___ cause.

Answer 7

genetic

Question 8

What are genetic studies used in the diagnosis of genetic MSK diseases?

Answer 8

Karyotyping

FISH (fluorescence in-situ hybridisation)

Question 9

FISH allows chromosomal ___ to be visualised.

Answer 9

translocations

Question 10

What is immunohistochemistry?

Answer 10

Target protein pigmented

If tumour cell produces target protein, it will light up

Question 11

What are characteristic traits of MSK tumours which aid in their identification?

Answer 11

Age group affected

Common sites (e.g the knee)

Appearance on radiology and histology

Question 12

Which group of people review patient cases before treatment is started?

Answer 12

MDTs

Question 13

What are some common benign lesions of connective tissue and bone?

Answer 13

Osteochondroma

Enchondroma

Cysts (bone cysts, ganglion cysts)

Giant cell tumours

Fibrous dysplasia

Fibromatosis

Question 14

Where are ganglion cysts commonly found?

Answer 14

Joint capsules - fingers, wrists, knees

Question 15

Ganglion cysts are herniations through the tendon ___.

Answer 15

sheathe

Question 16

Are ganglion cysts true cysts?

Answer 16

No, don’t have an epithelial lining

Question 17

Why are ganglion cysts hard?

Answer 17

Fibrous tissue

Question 18

What are some examples of fibromatoses?

Answer 18

Dupuytren’s contracture (thickening/sclerosis of palmar fascia)

Knuckle pads

Plantar fascia

Penile fascia - Peyronie’s disease

Question 19

dupuytren’s - association with alcohol + a ton of other things

Question 20

Fibromatoses all involve the formation of dense, contracted ___ tissue histologically.

They are (benign / malignant).

Answer 20

fibrous

benign

Question 21

Fibromatoses can be superficial or ___.

Answer 21

deep

Question 22

Where generally are giant cell tumours commonly found?

Answer 22

Bone

Tendons

Joints

Question 23

What do giant cells look like under the microscope?

Answer 23

Big

Multi-nucleate

Question 24

Giant cell tumours are (benign / malignant).

Answer 24

benign

Question 25

What are benign tumours of fat called?

Answer 25

**Lipomas**

Question 26

Where are the nuclei of adipose cells found?

Answer 26

**Periphery**

Question 27

What are benign tumours found in the forearms of young people which tend to be painful?

Answer 27

**Angiolipoma**

Question 28

angel? benign, painful lumps

Question 29

How do liposarcomas look compared to lipomas under the microscope?

Answer 29

**Presence of lipoblasts - dark purple blobs** - among the adipocytes

Question 30

Where are leiomyomas - benign tumours of smooth muscle - commonly found?

Answer 30

**Uterus**

Question 31

What is a malignant smooth muscle tumour called? Are they common?

Answer 31

**Leiomyosarcoma** **No**

Question 32

Which technique, involving protein tagging, is used to identify leiomyosarcoma?

Answer 32

**Immunohistochemistry**

Question 33

What are tumours of skeletal muscle called? In which group are they commonly found?

Answer 33

**Rhabdomyo(sarco)ma** Children

Question 34

What are tumours of cartilage called?

Answer 34

**Chondro(sarco)ma**

Question 35

What is a common benign cartilaginous tumour found in the smaller bones e.g digits?

Answer 35

**Enchondroma**

Question 36

Cartilaginous tumours found in the appendicular skeleton tend to be \_\_\_. Cartilaginous tumours found in the axial skeleton tend to be \_\_\_.

Answer 36

appendicular - **benign** axial - **malignant**

Question 37

osteomas - cranial bones gardner's syndrome

Question 38

Where do **osteoid osteomas** tend to occur?

Answer 38

**Long bones** Halo-appearance, extremely painful, young people

Question 39

How is the pain associated with osteoid osteomas treated?

Answer 39

**NSAIDs** (aspirin, ibuprofen)

Question 40

Osteoid osteomas are (benign / malignant).

Answer 40

**benign**

Question 41

What is the characteristic histological appearance of osteoid osteomas?

Answer 41

**Halo (nidus)**, spongy bone surrounded by hard bone

Question 42

What is a malignant bone tumour called? Which age group is usually affected? Which bones are usually affected?

Answer 42

**Osteosarcoma** **Young people** **Long bones**

Question 43

Any tumour producing **osteoid** (pink stuff on histology) should be treated as an \_\_\_\_.

Answer 43

**osteosarcoma**

Question 44

What is a common genetic condition causing malignant bone tumours?

Answer 44

**Ewing's sarcoma**

Question 45

Which age group tends to develop Ewing's sarcoma? Which bones are affected? What is the genetic cause?

Answer 45

**Young people** **Long bones** **Translocation of chromosomes 11 and 22**, t(11;22)

Question 46

What does Ewing's sarcoma look like on microscopy?

Answer 46

**Small round blue cells** resembles a lot of other things

Question 47

Ewing's sarcoma grow rapidly to enormous sizes, raising the ___ off the bone.

Answer 47

**periosteum**

Question 48

MSK tumours common in older people are ___ from other organs.

Answer 48

**metastases**

Question 49

figure out what sarcomatoid carcinomas are

Question 50

What is a pseudotumour?

Answer 50

Something that seems like a neoplasm but isn't actually

Question 51

nodular fasciitis commonly confused for malignancy

Question 52

What is myositis ossificans? What does it commonly occur following?

Answer 52

**Ossification of muscle** **Trauma**