Histopathology 2s Bone tumours

Question 1

Primary malignant bone tumours most common in…

Answer 1

Young adults and children

Question 2

Site predilection of osteosarcoma

Answer 2

around the knee

Question 3

bone tumour diagnosis method

Answer 3

X-ray + US guided Jamshidi needle biopsy

Question 4

Which sex and age group affected by fibrous dysplasia?

Answer 4

F>M, <30 years

Question 5

“soap bubble” osteolysis

Answer 5

Fibrous dysplasia

Question 6

Which bone tumour associated with GNAS mutation?

Answer 6

Fibrous dysplasia

Question 7

McCune Albright syndrome - what is it and which bone tumour is it associated with?

Answer 7

Fibrous dysplasia

Fibrous dysplasia + cafe au lait pots + endocrine abnormalities e.g. cushing’s/ precocious puberty

Question 8

Chinese letters in marrow (marrow replaced by fibrous stroma)

Answer 8

Fibrous dysplasia

Question 9

IS fibrous dysplasia benign or malignant?

Answer 9

BENIGN (<1% PROGRESS TO MALIGNANCT)

Question 10

What is the “Shepherd’s crook deformity”? and which disease is it seen in

Answer 10

Deformity of the femoral head seen in fibrous dysplasia due to micro fractures

Question 11

If tumour affects multiple bones, is it likely to be benign or malignant?

Answer 11

Benign, otherwise secondary mets

Question 12

Bony outgrowth with cartilage capped over it?

Answer 12

OsteoCHONDROMA (BENIGN)

Question 13

Which bones affected by osteochondroma?

Answer 13

long bones

Question 14

Which benign bone tumour tends to affect the hands?

Answer 14

Enchondroma

Question 15

Where is the cartilage found in endochdonromas?

Answer 15

WITHIN the bone

Question 16

Which bone tumour is borderline malignant? What is seen on histology?

Answer 16

Giant cell tumours - osteoclasts on a background of spindle/ovoid cells

Question 17

whY ARE Giant cell tumours considered borderline?

Answer 17

They can be locally aggressive, may recur and metastasise

Question 18

Giant cell tumours and osteochondroma, which is more common in men and which in women?

Answer 18

Osteochondroma - Men (10-20y)

Giant cell tumours - Women (20-40)

Question 19

What is the commonest malignant bone tumour?

Answer 19

METASTASIS

Question 20

Which 5 sites of primary cancer most commonly metastasise to the bone?

Answer 20

Breast
Lung
Prostate
Thyroid
Kidney

Question 21

coMMON primary for bone mets in children?

Answer 21

Neuroblastoma, Wilm’s tumour, Ewing’s sarcoma, osteosarcoma

Question 22

3 main types of malignant tumour

Answer 22

Osteosarcoma (forms bone)
Chondrosarcoma (Forms cartilage)
Ewing’s sarcoma (undifferentiated mesenchymal tumour)

Question 23

Most common bone sarcoma

Answer 23

Osteosarcoma

Question 24

Most common site of osteosarcoma?

Answer 24

KNEE

Question 25

coDMAN’S TRIANGLE?

Answer 25

Elevated periosteum on X-ray seen in osteosarcoma

Question 26

A malignant primary bone tumour seen commonly in older patients?

Answer 26

Chondrosarcoma

Question 27

Chondrosarcoma - X-ray features?

Answer 27

Lytic lesion + FLUFFY CALCIFICATION

Question 28

lOCATION of a majority of chondrosarcomas

Answer 28

Pelvis

Question 29

Small round blue cell tumour

Answer 29

Ewing’s sarcoma

Question 30

Onion skinning of periosteum (periosteal reaction), lytic +/- sclerosis (on X-ray)

Answer 30

Ewing’s sarcoma

Question 31

specific chromosome translocation t(11;22)

Answer 31

Ewing’s sarcoma

Question 32

Bone tumour +ve for ALP

Answer 32

Osteosarcoma

Question 33

Define a soft tissue tumour

Answer 33

Mesenchymal proliferation which occur in the extra-skeletal, non-epithelial tissues of the body

Question 34

Name 3 main classes of soft tissue tumorus

Answer 34

Liposarcoma (Fat), spindle cell sarcoma(muscle), pleomorphic sarcoma (Cannot tell cell of origin)