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HistoPath > Histopathology 2: Neoplastic Bone Disorders > Flashcards

Histopathology 2: Neoplastic Bone Disorders Flashcards

1
Q

X-ray: Codman’s Triangle at end of long bones
Histology: Malignant mesenchymal cells

Diagnosis?

A

Osteosarcoma

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2
Q

X-ray: Lytic lesions with fluffy calcification
Histology: Malignant chondrocytes

Diagnosis?

A

Chondrosarcoma

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3
Q

X-ray: Onion skinning of periosteum
Histology: Sheets of small round cells
Karyotype: shows t(11;22)

Diagnosis ?

A

Ewing’s sarcoma

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4
Q

X-ray: Lytic appearance in the epiphysis of knee
Histology: Giant cells look like osteoclasts, spindle/ovoid cells

Diagnosis?

A

Giant cell tumour

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5
Q

X-ray: Soap bubble osteolysis, Shepherd’s crook deformity
Histology: Chinese letters

Diagnosis ?
Associated syndrome ?

A

Fibrocystic dysplasia
Albright syndrome

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6
Q

List the triad of features Albright syndrome?

A
  • Polyostotic dysplasia
  • cafe au lait spots
  • Precocious puberty
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7
Q

X-ray: Mushroom protuberance from Bone
Histology: Cartilage capped bony outgrowth

Diagnosis?

A

Osteochondroma

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8
Q

X-ray: popcorn calcification
Histology: Proliferation of cartilage

Diagnosis ?

A

Enchondroma

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9
Q

X-ray: Bulls eye appearance of radioleucent nidus with sclerotic rim
Histology: normal bone arising from osteoblasts

Diagnosis ?

A

Osteoid Osteoma

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10
Q

Which benign bone tumour causes pain at night which is relieved by Aspirin ?

A

Osteoid osteoma

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11
Q

In which syndrome do you get Osteomas, GI polyps and epidermoid cysts ?

A

Gardner syndrome

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12
Q

Parts of the bone

A

long part = diaphysis (dying is long man)
end part = epiphysis

outside - inside = periosteum - cortex - medulla

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13
Q

list 5 tumour- like condition

A
  • fibrous dysplasia
  • metaphysial fibrous cortical defect/ non-ossifying fibroma
  • reparative giant cell granuloma
  • ossifying fibroma
  • simple bone cyst
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14
Q

Age group that Primary malignant bone tumours are more common

A

children and young adults

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15
Q

Where are bone tumours most common?

A

around the knee (distal femur or proximal tibia)

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16
Q

What part of the bone are metaphysis, diaphysis, and epiphysis?

A
  • diaphysis: long part (dying is long man)
  • epiphysis: EEEnds
  • metaphysis: middle/in between diaphysis and epiphysis
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17
Q

How to biopsy bone tumour

A

Needle core biopsy - using Jamshidi needle

done with USS or CT guidance

18
Q

Soap bubble X-ray appearance, which bone tumour?

A

Fibrous Dysplasia

19
Q

What bone tumour do you get in McCune Albright Syndrome, and which other Sx do you get?

A

polyostotic fibrous dysplasia (soap bubble lesion)

Other Sx: endocrine problems + café au lait spots

20
Q

Name if you see Fibrous Dysplasia in the Femoral Head

A

Shepherd’s Crook

21
Q

Benign bone tumours (6)

A

Cartilaginous differentiation

  • Osteochondroma
  • Enchondroma
  • Chondroblastoma

Bone Forming

  • Osteoid osteoma
  • Osteoblastoma
  • Osteoma
22
Q

Benign bone tumour with overgrowth of cartilage AND bone

A

Osteochondroma - mainly occur at the ends of long bones

Osteochondromas mimic the normal tubular bones- they have a cartilaginous surface overlying the normal cortical and trabecular bone

23
Q

Benign bone tumour - cartilaginous proliferation WITHIN the bone

Which bone do they mainly affect?

X-ray sign

A

Enchondromas

hands with some in the feet

X-ray: popcorn calcification’

24
Q
A
25
Q

Benign Bone Tumours May erode through the cortex of the bone but do NOT invade through what?

A

NOT burst through the articular (cartilaginous) surface

26
Q

Where on the bone does Ewing Sarcoma form?

A

diaphysis/ metaphysis of long bones, pelvis

27
Q

X-ray feature of onion skinning for which tumour?

Histology for this

A

Ewing sarcoma

Histology: small round cells

28
Q

5-year survival for Ewing sarcoma

A

75%

29
Q

Chromosomal translocation of Ewing sarcoma

A

translocation 11;22 (EWSR1/ Fli1) (q24;q12)

30
Q

X-ray lesion of fluffy calicification which bone tumour?

Which are the main bones affected?

What does the tumour produce?

A

Chondrosarcoma

axial skeleton, pelvis, proximal femur, proximal tibia

Produces cartilage

31
Q

X-ray of Giant Cell Tumour (Borderline Malignancy of bone)

Histology

A

lytic appearance

osteoclasts on a background of spindle/ ovoid cells

32
Q

Tumour of bone characterised by the presence of osteoclasts

A

Giant Cell Tumour (giant cells = osteoclasts - these are not neoplastic)

Can be locally aggressive, may recur and can metastasise through the blood vessels (to the lungs)

33
Q

What is the most common malignant bone tumour?

Which bones are they rarely found?

A

Tumours that metastasise to the bone

Below elbow and knee

34
Q

Adult cancers that spread to the bone (+ how to remember)

A

REMEMBER: 1-2-2-2-1

  • Thyroid
  • Breast
  • Lung
  • Kidney
  • Prostate
35
Q

Carcinoma is which type of tumour?

A

Epithelial cell tumour

36
Q

3 Malignant Bone Tumours (and what each produces)

A
  • Osteosarcoma (bone forming)
  • Chondrosarcoma (cartilage forming)
  • Ewing’s sarcoma/ PNET (primitive peripheral neuroectodermal tumour)
37
Q

What is a Malignant bone-forming tumour?

Which bone do you mainly find it?

A

Osteosarcoma (most common bone sarcoma)

  • at the ends of long bones (e.g.60% occur around the knee) - lower femur or upper tibia
  • Older people get in in their jaw
38
Q

Key sign of osteosarcoma on X-ray

A

Elevated periosteum (Codman’s triangle)

39
Q

Examples of soft tissue tumours (3)

A

Soft tissue tumour: mesenchymal proliferations which occur in the extra-skeletal, non-epithelial tissues of the body- excluding the meninges and lymphoreticular system. Can be found anywhere, but mostly in large muscles of the extremities

  • Myxoid Tumours- Liposarcoma (have myxoid appearance)
  • Spindle Cell Sarcoma (tissue can originate from nerve, muscle, fibrous tissue)
  • Pleomorphic Sarcoma
40
Q

Staging of soft tissue tumours

A

**INSERT THE PICS OF STAGING, FOLLOWED BY PROGNOSTIC FACTORS OF SOFT TISSUE TUMOURS**

HistoPath (21 decks)

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