Dougherty Part 4

Question 1

chondrosarcoma by definition has no what

Answer 1

malignant bone formation

Question 2

what are the types of chondrosarcomas based on calcificaiton of location

Answer 2

intramedullary

juxtacortical and surface

Question 3

what are the types of chondrosarcoma classified histologically

Answer 3

conventional (hyaline and/or myxoid)
clear cell
dedifferentiated
mesenchymal

Question 4

chondrosarcoma is seen in what ages

Answer 4

over 40

clear cell and mesenchymal occur in teens

Question 5

where does chondrosarcoma affect the skeleton

Answer 5

pelvis, shoulder, ribs

Question 6

15% of chondrosarcoma arise in what

Answer 6

enchondroma (higher risk with multiple enchondromas, and osteochondroma

Question 7

where is clear cell chondrosarcoma found

Answer 7

long tubular bone epiphyses

Question 8

what is seen on an X-ray of conventional chondrosarcoma

Answer 8

nodular growth with endosteal scalloping and flocculent densities from calcification
reactive thickened cortex bone

Question 9

where does conventional chondrosarcoma metastasize to

Answer 9

lungs

bone

Question 10

what is dedifferentiated chondrosarcoma

Answer 10

low-grade chondrosarcoma and high grade sarcoma

Question 11

clear cell chondrosarcoma is found in what patients and where

Answer 11

teens/young adults

epiphysis

Question 12

mesenchymal chondrosarcoma is found in what patients

Answer 12

teens/young adults

Question 13

fibrous cortical defect affects what age group

Answer 13

40% of children

Question 14

nonossifying fibroma is found in what age group

Answer 14

adolescent

Question 15

where can one find fibrous cortical defects

Answer 15

metaphysis/cortex

knee

Question 16

where can one find non ossifying fibroma

Answer 16

metapysis/cortex

knee

Question 17

what is the size of a fibrous cortical defect

Answer 17

small (less than 0.5cm)

Question 18

what is the size of a non ossifying fibroma

Answer 18

large up to 6cm

Question 19

fibrous dysplasia shows what 3 patterns

Answer 19

monostotic
polyostotic with soft tissue myxomas
polyostotic with endocrine dysfunction (McCune-Albright Syndrome)

Question 20

what is seen in McCune-Albright Syndrome

Answer 20

cafe aurait skin pigmentations

endocrine: sexual precocity (often presenting), hyperthyroidism, pituitary adenomas with GH, primary adrenal hyperplasia

Question 21

hyperactive G-protien of GNAS gene

Answer 21

McCune-Albright Syndrome

Question 22

McCune-Albright Syndrome is seen in what

Answer 22

fibrous dysplasia

Question 23

Chinese character woven bone in fibrous stroma is seen in what

Answer 23

fibrous dysplasia

Question 24

what is seen in fibrous dysplasia

Answer 24

well-circumsctibed intramedullary
large may expand and distort bone
gross: tan-white and gritty

Question 25

80% of Ewing Sarcoma is in what age group

Answer 25

less than 20 years

Question 26

what is ewing sarcoma

Answer 26

small round (blue) cell tumor of bone and soft tissue glycogen Homer-Wright Rosettes

Question 27

what is the issue in ewing sarcoma

Answer 27

EWS gene translocation | t(11;22) EWS-FLI1

Question 28

what is the difference between Ewing Sarcoma and Primative Neuroectodermal Tumor (PNET)

Answer 28

degree of neural differentiation

Question 29

where on the bone and in what bones is ewing sarcoma and PNET

Answer 29

diaphysis of long tubular bones (FEMUR) and flat bones of pelvis

Question 30

when would on see lytic destruction onionskin periosteal reaction and sunburst pattern

Answer 30

Ewing sarcoma | PNET

Question 31

what is Giant Cell Tumor of Bone

Answer 31

benign locally aggressive tumor of macrophage/monocyte system

Question 32

giant cell tumors are normally found where in the bone

Answer 32

epiphyses but may extend into the metaphysis

Question 33

where are giant cell tumors most commonly found

Answer 33

knee

Question 34

in giant cell tumors mononuclear cells express what

Answer 34

RANKL

Question 35

grossly what does one see in giant cell tumor of bone

Answer 35

brown from hemosiderin

Question 36

what is seen in Aneurysmal Bone Cyst (ABC)

Answer 36

pain and swelling multiloculated blood-filled cysts rapid growth may appear malignant

Question 37

aneurysmal bone cyst (ABC) is common in what ages

Answer 37

below 20

Question 38

where and in which bones is aneurysmal bone cyst (ABC) found

Answer 38

metaphysis long bones vertebrae

Question 39

what histological features are seen in Aneurysmal Bone Cyst

Answer 39

blood filled cysts separated by internal septae fibroblasts and multinucleate giant cells woven bone

Question 40

what is the most common form of skeletal malignancy

Answer 40

metastatic disease

Question 41

what is the pathway of spread in metastatic disease

Answer 41

direct extension lymphatic or hematogenous intraspinal seeding (Baston plexus of veins)

Question 42

adult metastatic disease is commonly from where

Answer 42

"BLT and a Kosher Pickle" | Breast, lung, thyroid, kidney, prostate

Question 43

metastatic disease is most often found where

Answer 43

axial skeleton

Question 44

osteoblastic metastases in the vertebral column is most likely from where

Answer 44

patient with metastatic adenocarcinoma of prostate

Question 45

what are peidatric metastatic diseases

Answer 45

``` Neuroblastoma Wilms Tumor Osteosarcoma Ewing sarcoma Rhabdomyosarcoma ```