Flashcards in Bone Tumors Deck (42):
Bosselated, round sessile tumor projecting from the subperiosteal surface on or inside the skull and facial bones in middle aged adults
What is the osteoma composed of?
Woven or lamellar bone
Trabecular bone with marrow
Happens in teens and 20s
Worse at night
Relieved by NSAIDs
Arises in femur or tibia
What is a osteoblastoma composed of?
Woven bone and osteoblasts with stroma of loose CT and dilate congested capillaries
Radiation promotes malignancy
Need to resect to prevent recurrence
How is an osteoblastoma different from and osteoid osteoma?
The pain is dull and achy
It doesn't respond to NSAIDs
Involved the spine
What is the most common primary malignancy of bone?
What are the genetic mutations associated with osteosarcoma?
Who gets osteosarcoma?
75% younger than 20
And the elderly with paget's, irradiation, bone infarcts
Where is it most likely to show up?
In the metaphysis of long bones intramedullary - around the knee
Forms bone with coarse lace like architecture, destroys cornices and produces soft tissue mass
X-ray: shows lytic and blastic lesions
What other disease is osteosarcoma associated with?
Benign cartilage capped outgrowth near the growth plate of long tubular bones
Benign hyaline cartilage cap
Painful if impinged in nerves or stalk is fractured
What is the most common intraosseous cartilage tumor?
Solitary, short tubular bones of hands and feet
Gray blue tumor
What is Ollier disease?
What is maffucci syndrome?
Endochondromatosis and soft tissue hemangiomas
Can lead to ovarian carcinoma and brain gliomas
O ring sign on X-ray
Neoplastic chondrocytes that reside in lacunae
Unmineralized Nodules of cartilage on X-rays
In young teens, males more than females
Epiphysis and apophyses
Composed of sheets of chondroblasts
Hyaline matrix with lace like configuration = chicken wire
X-ray shows spotty calcification
Painful with effusion and restrict joint mobility
Arise in metaphysis of long bones
Has chondrocytes in lacunae and stellate cells in the myxoid area
Dull achy pain
X-rays : eccentric geographic lucency with well delineated from adjacent bone by rim of sclerosis
No malignant transformation
Produces neoplasticism cartilage
Large bulky tumor of malignant hyaline and myxoid cartilage
Spotty calcification with central necrosis
Broad pushing fronts
Arise in central skeleton
What clear cell chondrosarcoma?
Sheets of large malignant chondrocytes with abundant clear cytoplasm, intralesional reactive bone formation
Seen in teens
In epiphysis of long bones
Islands of well differentiated hyaline cartilage with sheets of small round cells
What is the most common tumor of adulthood?
Mobile painless mass
Arise in deep soft tissues of proximal extremities and retroperitoneum
Pleomorphic variants and round cell variants are aggressive with frequent mets
Most common in the lower extremities
Translocation to ch.18 produces fusion of SYT-SSX1/2
Most common in 20s to 40s
Biphasic differentiation: epithelial cells and spindle cells
Calcified concretions on X-rays
Rxns for keratin and epithelial membrane Ag
What is the most common neoplasm in women?
Spindle cells intersecting at right angles
Arise in uterus nipples, scrotum
Blunt ended, elongated nuclei
Develop in the skin and deep soft tissues of extremities and retroperitoneum
Cigar shaped nuclei
Malignant SMCs with dense bodies and pinocytotic vesicles
Stain with abs for vimentin, actin, SM actin, desmin
What is the most common soft tissue sarcoma of childhood?
Translocation 2;13 = PAX3 fuses with FKHR --- dysregulation of muscle differentiation
Eccentric Eosinophilic granular cytoplasm rich in thick and thin filaments
Tadpole or strap cells
Sarcomeres stain with Ab to desmin, MYOD1, myogenin
What is the rhabdomyosarcoma variant with the worst prognosis?
Children younger than 10
Grape like lesions in mucosal cavities
Allelic loss of ch.11p15.5
Cambium layer with hypercellularity