Final Flashcards
1
Q
T or F
Osteoma will develop on intramembranous bones
A
True
2
Q
T or F
Osteoma will develop on intramembranous bones
A
True
3
Q
What is an Osteoma?
A
A mass of cortical bone projecting out from the cortex. Diff Dx = bone island inside medullary canal
4
Q
Common locations for Osteoma?
A
Calvarium
Paranasal Sinuses - ethmoid and frontal (not so much maxillary)
Sometimes in Mandible
5
Q
What is Gardner Syndrome?
A
aka Familial Colorectal Polyposis is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon.
6
Q
The extracolonic tumors associated with Gardner Syndrome are found typically where?
A
Osteoma of the skull
Thyroid Cancer
Epidermoid Cysts
Fibromas
7
Q
What size are Osteomas typically?
A
2 cm
8
Q
Osteoid Osteoma common sites
A
50% Tibia and Femur
10% Spine
Long bones, metaphysical or diaphysial
9
Q
Osteoid Osteoma represents approx what percent of all benign bone tumors?
A
11%
10
Q
T or F
Females : male and Osteoid Osteoma = 2:1
A
False
Opposite
11
Q
What is the classic clinical manifestation of Osteoid Osteoma?
A
Pain worse at night, relieved by aspirin
12
Q
Osteoid Osteomas will reoccur if what is not removed from the lesion?
A
The Nidus
13
Q
O.O is one of 3 primary bone tumors that predicts what part of the body?
A
Posterior elements of the spine
14
Q
T or F
Osteoblastoma is not blastic but rather radiolucent
A
True
15
Q
Where do 30-50% of Osteoblastomas occur in the body?
A
Posterior arch of the spine
16
Q
Knock Knock
Who’s there?
Itsa
Itss who?
A
Itsa bitch studying this bullshit
17
Q
List some of the radiographic findings of Osteoblastomas
A
- Expansile, geographic
- 2-12 cm dis with Matrix lucent but may have stifled calcification
- Often sclerotic border and sharp zone of transition
- Usually lacks reactive dense reactive sclerosis of osteoid osteoma
18
Q
What is an Osteoma?
A
A mass of cortical bone projecting out from the cortex. Diff Dx = bone island inside medullary canal
19
Q
Common locations for Osteoma?
A
Calvarium
Paranasal Sinuses - ethmoid and frontal (not so much maxillary)
Sometimes in Mandible
20
Q
What is Gardner Syndrome?
A
aka Familial Colorectal Polyposis is an autosomal dominant form of polyposis characterized by the presence of multiple polyps in the colon together with tumors outside the colon.
21
Q
The extracolonic tumors associated with Gardner Syndrome are found typically where?
A
Esteem of the skull
Thyroid Cancer
Epidermoid Cysts
Fibromas
22
Q
fuck off
A
bitch
23
Q
Osteoid Osteoma common sites
A
50% Tibia and Femur
10% Spine
Long bones, metaphysical or diaphysial
24
Q
Osteoid Osteoma represents approx what percent of all benign bone tumors?
A
11%
25
T or F
Females : male and Osteoid Osteoma = 2:1
False
Opposite
26
What is the classic clinical manifestation of Osteoid Osteoma?
Pain worse at night, relieved by aspirin
27
Osteoid Osteomas will reoccur if what is not removed from the lesion?
The Nidus
28
O.O is one of 3 primary bone tumors that predicts what part of the body?
Posterior elements of the spine
29
T or F
Osteoblastoma is not blastic but rather radiolucent
True
30
Where do 30-50% of Osteoblastomas occur in the body?
Posterior arch of the spine
31
What long bones are the MC for Osteoblastomas?
Femur & Tibia
| Diaphyseal & Metaphyseal Location
32
List some of the radiographic findings of Osteoblastomas
- Expansile, geographic
- 2-12 cm dis with Matrix lucent but may have stifled calcification
- Often sclerotic border and sharp zone of transition
- Usually lacks reactive dense reactive sclerosis of osteoid osteoma
33
What is an important differential dx to include with Osteoblastoma?
ABC = aneurismal bone cyst
34
What is the second most common primary malignancy of bone?
Osteosarcoma
35
What percent of all primary malignancies of bone does Osteosarcoma represent?
20%
36
75% of Osteosarcoma's occur between what age groups?
10-25 yo
37
T or F
| Osteosarcoma is 2:1 male:female
True
38
With Osteosarcoma we will see elevated serum levels of...
Alkaline Phosphatase
39
What are the MC subtypes: "conventional" of Osteosarcoma?
Parosteal
Periosteal
Multicentric
40
What are the most common sites for Osteosarcoma?
Knee
Proximal Humerus
** reported almost everywhere
41
Name the basic patterns of Osteosarcoma and their relative %
```
Sclerotic = 50%
Lytic = 25%
Mixed = 25%
```
42
T or F
The periosteal rxn with Osteosarcoma is solid/lamellated
False
Sunburst or Speculated
43
T or F
Osteosarcoma will create permeative or moth-eaten bone lysis
True
44
What is the tx for Osteosarcoma?
Amputation and chemo
45
Parosteal Osteosarcoma is also known as?
Juxtacortical Sarcoma
46
T or F
Parosteal Osteosarcoma is faster growing and more aggressive than typical Osteosarcoma
False
Slower and less aggressive.
47
What age group is typical for Parosteal Osteosarc?
2nd-4th decaades
48
What bones does Parosteal Osteosarc like?
92% Femur!!!
| Tibia, humerus
49
What are the 2 types of juxtacortical sarcomas that are based on the relative amounts of fibrous, cartilage and osteoid tissue present...
1. Parosteal Osteosarcoma
| 2. Periosteal Osteogenic Sarcoma
50
T or F
Parosteal Osteosarcoma arises as dense non-homogenous, ossified mass attached by a thick pedicle to adjacent bone usually in the metaphyseal area
False
HOMOGENOUS!!
*all the rest is true
51
Do you see underlying medullary bone being violated in Parosteal or Periosteal Osteosarcoma?
Parosteal
52
Histologically this bone tumor is derived from rests of hyaline cartilage cells separated from the physis...
Enchondroma
53
Enchondromas represent what percent of all benign bone tumors?
10%
54
50% of Enchondromas occur in what bones of the body?
Small bones of the hands
55
T or F
Enchondromas are common in the distal phalanges and carpals
False
56
What is the most common benign bone tumor of the hand?
Enchondroma
57
Enchondromatosis aka ?
Ollie's Disease
58
What is Ollier's Disease (Enchondromatosis)
Multiple enchondromata (usually affecting one side of the body) and is considered dysplasia, rather than neoplastic process.
59
Are enchondromas typically blastic or radiolucent?
Radiolucent
60
In long bones the d/dx of Enchondroma should include what other pathology?
Medullary Bone Infarct
61
What is Maffucci's Syndrome?
Enchondromatosis and the presence of soft tissue hemangiomas
62
This type of tumor is an osseous projection from the cortex with a cartilagenous "cap" and is thought to arise from isolated physeal cells.
Osteochondroma
63
What is the most common benign bone tumor?
Osteochondroma
| * 50% of all reported benign bone tumors
64
50% of Osteochondroma's predilict where?
Lower extremity; esp femur and tibia
65
T or F
Giant cell is typically concentric
False
Eccentric
66
T or F
Osteochondroma develops in children
True
67
What are the two types of Osteochondromas?
1. Pedunculate (with stalk)
| 2. Sessile (broad based)
68
T or F
Hemangioma's will typically expand the bone
False
Does not and is commonly termed Barrel Vertebra
69
What is a big difference between the multiple osteochondroma's and the solitary variety?
The multiple as in HME are predisposed to malignant degeneration (some estimate up to 25% of cases)
70
Chondroblastoma was previously referred to as?
Codman's Tumor
71
What is the name of the malignant lesion of chondroblastic origin that may arise in any bone preformed in cartilage?
Chondrosarcoma
72
What is the age range for Chondrosarcoma?
Wide range
| 50% > age 40
73
T or F
Chondrosarcoma's are fast growing
False
| slow growing and often develop over years.
74
Giant cell tumor aka ?
Osteoclastoma
75
Osteoclastoma is often considered a "quasi malignant" tumor that is histologically graded I-III. Please identify the grades
```
I = benign lesions
II = intermediate
III = frankly malignant
```
76
What percent of Giant Cell Tumors are benign?
80%
77
T or F
Males are more commonly affected by Giant Cell Tumors
False
males = females
78
What is the age range for Giant Cell Tumors
most in 20-40 yr. range
79
What are the common sites for Giant Cells?
Femur (distal)
Radius (distal)
Humerus (proximal)
80
T or F
Giant Cell is considered a metaphyseal lesion
True
81
T or F
Giant cell is typically concentric
False
Eccentric
82
Where in the body are Hemangioma's common?
Spine and Calvarium
83
A corduroy stripe appearance is common with what condition?
Hemangioma
84
T or F
Hemangioma's will typically expand the bone
False
Does not and is commonly termed Barrel Vertebra
85
Name the Osteoid/bone origin benign tumors
```
Osteoid Osteoma
Osteoblastoma
Osteoma
Osteoclastoma (Giant Cell)
Bone Island
```
86
What is the name of the Osteoid origin malignant tumor?
Osteosarcoma
87
Cartilage origin benign tumors
Enchondroma
Chondroblastoma
Osteochondroma
Chondromyxoid Fibroma
88
What is the malignant Cartilage in origin tumor?
Chondrosarcoma
89
What is the name of the MC malignant bone tumor in children?
Ewings Tumor
90
What is the name of the fluid-filled cystic lesion
Unicameral bone cyst - aka simple bone cyst
| Aneurysm bone "cyst"
91
What tumors are cystic looking but no fluid...
Intraosseous Lipoma
| Giant Cell Tumor
92
Most common tumor and tumor like lesions of bone are malignant or benign?
Benign
93
Most malignant bone lesions are primary or secondary?
Secondary
94
The most common primary malignancy of adult bone and the spine is?
Multiple Myeloma
95
Most metastatic lesions to bone arise from what primary sites?
Breast
Prostate
Kidney
Lung
96
Most metastatic bone lesions are located in the appendicular or axial skeleton and are rare....
Axial
| Rare distal to the elbow or knees
97
The term for a primary malignancy of connective tissue origin is?
Sarcoma
98
Term describing multiple larger destructive areas with poorly defined margins and cortical destruction
Moth-eaten (punched-out)
99
Term for a focal area of well localized destruction with complete border and clearly defined margins between the lesion and adjacent normal bone.
Geographic
100
Term for destruction of local area with many tiny lytic lesions centrally and gradually fewer and fewer peripherally, fading into normal bone...
Permeative
101
T or F
The majority of metastatic lesions to the skeleton are blastic
False
Lytic
102
Because of the variety of X-Ray appearances, two tumor like disorders of bone sometimes referred to as the "great imitators" of bone diseases are....
Paget's
| Fibrous Dysplasia
103
The most common location for tumors to occur in long bones is?
Metaphysis
104
T or F
Geographic lesions that expand cortex are more commonly associated with malignant histology
False
Benign...but be aware of the geographic lesion without sclerotic margins or destroying (no expanding) cortex
105
Popcorn or "rings/broken rings" of calcification often implies what tissue?
Cartilage
106
Aka for Unicameral Bone Cyst
Simple Bone Cyst
107
80% of Unicameral bone cysts occur between what ages?
3-14yrs
108
Where do 75% of Simple bone cysts occur in the body?
Proximal humerus and proximal femur
109
T or F
Active lesions (bone cysts) "drift away" from physeal plate to metadiaphysis
False
Active lesions maintain position adjacent to physeal plate.
110
Fallen fragment sign is associated with what pathological process
Unicameral bone cyst
111
Fibroxanthoma includes two similar lesions. What are they named?
Benign Fibrous Cortical Defect BFCD
| Non-ossifying fibroma
112
T or F
Typical the NOF is associated with a larger, more clinically significant lesion that may not resolve as compared to the BFCD
True
BFCD usually refers to a smaller, epihumeral lesion that is more a variant of growth than neoplasm.
113
What is the common location for BFCD?
Metaphyseal/metadiaphyseal
| Juxtacortical location
114
Name the 3 presentations of Fibrous Dysplasia and their relative occurrence in %
Monostotic - 75%
Polyostotic - 25%
Poluostotic with associate endocrine anomaly - rare
115
Do we see any destruction of cortex or a periosteal rxn with Fibrous Dysplasia?
Bone expansion is common with INTACT cortex, thinned maybe, but not destroyed.
No periosteal rxn or soft tissue mass
116
Polyostotic Fibrous Dysplasia in the hands can mimic what other disease?
Ollier's
117
Where do aneurysmal bone cysts usually develop?
80% long bone metaphyes usually eccentrically placed or post. arch of spine.
118
T or F
Cortex is often thickened in aneurysmal bone cysts
False
| Cortex is usually thinned to imperceptible - can mimic "blowout" type metastatic lesion.
119
T or F
Ewings Tumor is Female predominant
False
Males > females 2:1
age 5-30 with peak at 15
120
S&S of Ewings tumor may mimic what other pathology of the bone?
Infection
- Fever
- Elevated ESR
- Elevated WBC
121
Describe the pattern of bone destruction and periosteal response with Ewings
Motheaten/Permeative
Reactive Sclerosis
Classically layered or lamented in "onionskin" pattern
122
T or F
| Ewings will typically affect flat bones in younger patients and long bones in older patients.
False
Opposite
123
T or F
Ewings is often in the metaphysis
False
Diaphyseal
124
What cell type is involved with Non-Hodgkin Lymphoma?
Post-germinal center B-cells
125
What is Stage 1 of the Ann Arbor Staging System for NHL
Stage 1 = primary lesion only (node, bone, other)
126
What is Stage 2 of the Ann Arbor Staging System for NHL
Stage 2 = nodes inovled in more than two anatomic regions on the same side of the diaphragm
127
What is the last stage of the Ann Arbor System for NHL
Stage 4 = Bony Mets
128
What are the general classifications for Non-Hodgkins Lymphomas?
Low Grade
Intermediate Grade
High Grade
Miscellaneous
129
Malignant proliferation of plasma cells with infiltration of bone marrow is known as...
Plasma Cell (Multiple) Myeloma
130
What are the 2 presentations of Plasma Myeloma?
1. Multiple Myeloma - 75%
| 2. Plasmacytoma - 25%
