Histopathology - Neoplastic Bone Disease Flashcards

(50 cards)

1
Q

What are some features of benign bone diseases on XR?

A
  • No periosteal reaction
  • Thick endosteal reaction
  • Regular bone formation
  • Intraosseous + regular calcification
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2
Q

What are some features of malignant bone disease on XR?

A
  • Acute periosteal reaction (Codman’s triangle, Onion skin, Sunburst)
  • Brioad border between lesion + normal bone
  • Varied bone formation
  • Extraosseous + irregular calcification
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3
Q

What is the epidemiology of an Osteosarcoma?

A
  • Adolescence
  • V. rare (60% less rare than lung cancer)
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4
Q

What bone is characteristically affected in Osteosarcoma?

A

Knee (60%)

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5
Q

What is seen on histiology for Osteosarcoma?

A
  • Malignant mesenchymal cells
  • ALP +ve
  • Replacement of bone marrow with trabecular bone
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6
Q

What is the XR appearance of Osteosarcoma?

A
  • Elevated periosteum (Codman’s triangle)
  • Sunburst appearance
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7
Q

What is the epidemiology of Chondrosarcoma?

A

> 40yrs

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8
Q

What bones are typically affected by Chondrosarcoma?

A
  • Axial skeleton
  • Femur
  • Tibia
  • Pelvis
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9
Q

What is seen on histology of Chondrosarcoma?

A
  • Malignant chondrocytes (proliferation of cartilage)
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10
Q

What is seen on XR of Chondrosarcoma?

A
  • Lytic lesino with FLUFFY CALCIFICATION
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11
Q

What are the malignant bone cancers?

A
  • Osteosarcoma
  • Chondrosarcoma
  • Ewing’s sarcoma
  • Giant cell
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12
Q

What is the epidemiology of Ewing’s sarcoma?

A
  • <20yrs
  • HIGHLY MALIGNANT
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13
Q

What bones are commonly affected in Ewing’s sarcoma?

A
  • Long bones
  • Pelvis
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14
Q

What are the histological features of Ewing’s sarcoma?

A
  • Sheets of SMALL ROUND CELLS
  • CD99 +VE
  • T 11:22 translocation
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15
Q

What is seen on XR of Ewing’s sarcoma?

A
  • ONION SKINNING of periosteum
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16
Q

What is the epidemiology of giant cell cancer?

A
  • 20-40yrs
  • F>M
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17
Q

What bones are commonly affected in giant cell cancer?

A
  • Knee (epiphysis)
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18
Q

What are the histological features of giant cell cancer?

A
  • Osteoclasts + stromal cells
  • Soap bubble appearance
  • Giant multi-nucleate osteoclasts
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19
Q

What is seen on XR of giant cell cancer?

A
  • Lytic/lucent lesions right up to articular surface
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20
Q

What are the benign bone tumours?

A
  • Osteoid Osteoma
  • Osteoma
  • Enchondroma
  • Osteochondroma
  • Fibrous dysplasia
  • Simple bone cyst
  • Osteoblastoma
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21
Q

What is the epidemiology of Osteoid Osteoma?

A
  • Adolescent
  • M:F = 2:1
22
Q

What bones are typically affected in Osteoid Osteoma?

A
  • Tibia diaphysis
  • Proximal femur
23
Q

What are the special features of Osteoid Osteoma?

A
  • Small benign bone forming lesion
  • Night pain relieved by aspirin
24
Q

What is seen on histology of Osteoid Osteoma?

A
  • Normal bone
  • Arises from Osteoblasts
25
What is seen on XR of Osteoid Osteoma?
- Central nidus (luscent) - Sclerotic rim (opaque) - Bull's eye
26
What is the epidemiology of Osteoma?
- Middle age
27
What bones are commonly affected by Osteoma?
- Head - Kneck
28
What are the special features of Osteomas?
- Bony outgrowths attached to normal bone Gardner Syndrome: - GI polyps - Multiple Osteomas - Epidermoid cysts
29
What is seen on histology of Osteoma?
Normal bone
30
What is the epidemiology of Enchondroma?
- Middle age
31
What bones are typically affected by Echondroma?
- Hands (43%)
32
What bones are typically affected by Echondroma?
- Hands
33
What are the special features of Echondroma?
- Benign tumours of cartilage - Ollier's syndrome = Multiple echondromas - Maffuci's syndrome = Multiple echondromas + haemangiomas
34
What is seen on histology for Echondromas?
- Normal cartilage - Calcified matrix
35
What is seen on XR for Echondromas?
- Lytic lesion - Cotton wool calcifications - Expansile - O ring sign
36
What is the epidemiology of Osteochondromas?
- Adolescent - Most common benign tumour
37
What bones are commonly affected in Osteochondromas?
- Metaphysis of long bones near tendon attachment sites
38
What are the special features of Osteochrondromas?
- Cartilage capped bony outgrowth - Diaphyseal aclasis/hereditary multiple exostoses = mulitple exostoses + short stature + bone deformities
39
What is seen on hitsology of Osteochondromas?
- Cartilage capped mushroom bony outgrowth
40
What is seen on XR of Osteochondromas?
- Well defined bony protuberance from bone - Cartilage capped bony spur on surface of bone "mushroom" on XR
41
What is the epidemiology of fibrous dysplasia?
- F>M - Middle age
42
What bones are most commonly affected in fibrous dysplasia?
- Femur - Ribs
43
What are the special features of fibrous dysplasia?
- A bit of bone is replaced by fibrous tissue McCune-Albright Syndrome: - Polyostotic dysplasia - Cafe au lait spots - Precocious puberty
44
What is seen on histology for fibrous dysplasia?
- Chinese letters (misshapen bone trabeculae)
45
What is seen on XR of fibrous dysplasia?
- Soap bubble osteolysis - Shepherd's crook deformity
46
Which bones are commonly affected in a simple bone cyst?
- Humerus - Femur
47
What is the special feature of a simple bone cyst?
- Fluid filled unilocular
48
What is seen on XR for a simple bone cyst?
- Lytic - Well defined
49
What is a special feature of Osteoblastoma?
- Similar to osteoid osteoma (small beningn bone forming lesion, night pain releived by aspirin)
50
What is seen on XR for Osteoblastoma?
- Speckled mineralisation