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Bone Path 4 > Mets And Primary > Flashcards

Mets And Primary Flashcards

1
Q

MC spine (tx/lx); axial skeleton, skull, prox extremeties

A

Mets general

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2
Q

MC 1’ sites of general mets

A 
Breast
Lung
Prostate
Kidney
Thyroid
Bowel
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3
Q

MC age for general mets

A

> 40

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4
Q

Motheaten - permeative lytic (MC) or blastic depending on primary CA (ivory vertebra = 3 Main causes)

A

Mets, general

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5
Q

2-4 cm, polystotic (only 10% are solitary), cortical destruction, no periosteal response, indistinct margins, occasional soft tissue mass

A

Mets - general

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6
Q

Weight loss, cachexia, anemia, fever

A

General mets

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7
Q

MC cause of missig pedicle

A

Osteolytic mets

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8
Q

Motheaten or permeative lytic

A

Primary tumors

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9
Q

> 6cm, monostotic, cortical destruction, aggressive periosteal response, indistinct margins, soft tissue masses

A

Primary tumors

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10
Q

Plasma cell (round cell neoplasm) matrix; same location as mets plus humerus and femur diaphysis

A

MM

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11
Q

Age range for MM and sex

A

50-70 (rare <40)

Males

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12
Q

Lytic - multiple. Punched out defects - high incidence of pathologic fx (20%)

A

MM

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13
Q

Normocytic/normochromic anemia and thrombocytopenia, renal disease, abnormal serum and urinary protein/reversed A/G ratio, elevated ESR/CA/uric acid/Rouleaux formation

A

MM

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14
Q

M spike
Bence jones protein in urine
Bone marrow aspirate

A

MM

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15
Q

MC cause of death: bacterial PNA and renal dz (myeloma kidney)

A

MM

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16
Q

Localized plasma cell neoplasm. Mandible, ilium, vertebrae, ribs, prox. Femur, scapula

A

Solitary plasmacytoma

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17
Q

Age/sex for solitary plasmacytoma

A

<50 in 50%

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18
Q

Geographic lytic (“soap bubbly”) and highly expansile

A

Solitary plasmacytoma

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19
Q

70% develop MM within 5 years

A

Solitary plasmacytoma

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20
Q

connective tissue; center of bone = MC, 75% in metaphysis of long bone; NOT common in vertebrae

A

Osteosarcoma

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21
Q

Age/sex of osteosarcoma

A

10-25 (75%)

Males

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22
Q

Possible fever, increased ALP

A

Osteosarcoma

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23
Q

Osteosarcoma painful?

A

Yes. And swelling. Onset of sx = dx is >6 months

24
Q

Cumulus could appearance
Cortical disruption
Spiculated periosteal response
Soft tissue mass

A

Osteosarcoma

25
Q

Mets to lungs common

A

Osteosarcoma

Do a chest CT

26
Q

Cannonball mets

A

Osteosarcoma

Mets to lungs.

27
Q

Cartilaginous matrix and bones preformed in cartilage in metaphyseal or diaphyseal (mc pelvis and prox femur; many other places too)

A

Chondrosarcoma

28
Q

MC primary Ca of hand, sternum and scapula

A

Chondrosarcoma

29
Q

Age/sex for chondrosarcoma

A

40-60

Males

30
Q

Painful mets/primary tumors

A 
MM
Solitary plasmacytoma
Osteosarcoma
Chondrosarcoma
Ewings
Fibrosarcoma
Chordoma
Hodgkin's lymphoma
31
Q

Large and poorly defined with endosteal scalloping

A

Chondrosarcoma

32
Q

Popcorn or stippled

A

Chondrosarcoma

33
Q

Grows slowly, symptoms from 2-5 years

A

Chondrosarcoma

34
Q

Ddx for chondrosarcoma

A

Enchondroma

Osteochondroma

35
Q

Marrow of long bones (round cell) in diaphysis
FLAT BONES
Rare in spine

A

Ewing’s sarcoma

36
Q

Age/sex of ewing’s

A

10-25/30
Males
UNCOMMON IN BLACKS

37
Q

Fever, anemia, leukocytosis, increased ESR

A

Ewing’s

38
Q

Aggressive periosteal response (lamintaed) with wide zone of transition

A

Ewing’s

39
Q

Mimics infections, common mets to lungs

A

Ewing’s

40
Q 
Long bones (MC knee)
Mets late to liver, lung, lymph, brain
A

Fibrosarcoma

41
Q

age/sex of fibrosarcoma

A

30-50

42
Q

Highly destructive, expanding, ST mass but no periosteal reaction!!!

A

Fibrosarcoma!

43
Q

Notochordal remnant cells left behind b/w skull base and coccyx. Mc in sacrococcygeal

A

Chordoma

44
Q

Age/sex of chordoma

A

40-70

Males

45
Q

Cortical expansion; may increase AP diameter of sacrum; calcification in 50%; ST mass

A

Chordoma

46
Q

Only primary malignancy to cross IVD space!!

A

Chordoma

47
Q

DDX for chordoma

A 
Lytic mets
Chondrosarcoma
GCT
ABC
Plasmacytoma
48
Q

Extranodal lymphoma in femur, tibia, humerus

A

Non-hodgkin’s lymphoma

49
Q

Age/sex of non-hodgkin’s lymphoma

A

20-50

Males

50
Q

Local, intermittent pain: dull, aching, not relieved by rest

A

Non-hodgkin’s lymphoma

51
Q

Minimal periosteal response, soft tissue mass

A

Non-hodgkin’s lymphoma

52
Q

Patient is generally healthy, often palpable mass or swelling

A

Non-hodgkin’s lymphoma

53
Q

MC in vertebral body, IVORY VERTEBRAh

A

Hodgkin’s lymphoma

54
Q

MC symptom of hodgkin’s lymphoma

A

PAIN

55
Q

Anterior scalloping

A

Hodgkin’s lymphoma

56
Q

Polyostotic, exuberent periosteal response,

A

Hodgkin’s lymphoma

57
Q

Ddx for hodgkin’s lymphoma

A

Blast mets, paget’s

Bone Path 4 (3 decks)

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