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MSK neoplasms Flashcards

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1
Q

epiphysis

A

top and bottom ends of bone

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2
Q

diaphysis

A

long middle part f the bone

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3
Q

metaphysis

A

interface between diaphysis and the epiphysis
(neck of bone)
in skeletally immature individuals - this is the site of the growth plate

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4
Q

cortex

A

thick outer shell of the bone
compact bone
cortical bone

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5
Q

medullary cavity

A

made of pongy bone and bone marrow

also called trabecular or cancellous bone

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6
Q

lamellar bone

A

mature bone

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7
Q

woven bone

A

osteoid (in context of a tumour producing immatuure bone)

immature/new bone

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8
Q

appendicular skeleton

A

shoulder and pelvic girdle, long bones, short tubular bones of the hands and feet

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9
Q

axial skeleton

A

skull, vertebral bodies and ribs

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10
Q

3 main categories of bone tumours

A
  • metastatic disease (most common)
  • haematolymphoid malignancies (plasma cell myeloma, primary bone lymphoma)
  • primary bone tumours (rare in comparison to metastases and haematolymphoid malignancies)
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11
Q

primary sites giving rise to metastases in bone

A

lung, breast, prostate, colorectal adenocarcinoma
malignant melanoma
thyroid (follicular) adenocarcinoma
renal cell carcinoma

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12
Q

2 groups of metastases to bone

A

osteolytic vs osteoblastic metastases

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13
Q

osteolytic metastases

A

bone destruction by tumour cells

cytokines released by the tumour stimulate osteoclastic bone resorption (by osteocllast cells)

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14
Q

osteoblastic (sclerotic) metastases

A

cytokines stimulate osteoblastic activity and new bone
typical of prostate and breast carcinoma
less common that oosteolytic

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15
Q

plasma cell myeloma definition

A

previously called multiple myeloma
bone marrow-based malignant neoplasm of plasma cells
forms multiple tumours throughout skeletal system

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16
Q

incidence of plasma cell myeloma

A

most common primary malignancy of bone

usually >50 years old M=F

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17
Q

clinica manifestation of bone pain, pathological fracture

A

multiple tumours in bone

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18
Q

clinical manifestation of hypercalcaemia

A

osteoclastic bone destruction

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19
Q

clinical manifestation of monoconal immunoglobulin in serum and urine (paraprotein/M protein)

A

clonal proliferation of plasma cells

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20
Q

clinical manifestation of renal failure

A

paraprotein deposits in kidney

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21
Q

clinical manifestation of susceptibility to infection

A

abnormal immunoglobulin

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22
Q

clinical manifestation of anaemia

A

chronic neoplastic disease

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23
Q

features of plasma cell myeloma

A

multiple lytic lesions throughout skeletal system (especially axial skeleton)
malignant proliferation of plasma cells forming tumorous masses within bone

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24
Q

features of bone tumours

A

relatively constant clinicopathological features across age group, are affected, radiological features and pathological features

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25
define osteosarcoma
malignant mesenchymal neoplasm (sarcoma) producing bone matrix (osteoid/immature bone)
26
incidence of osteosarcoma
most common primary malignant tumour of bone (excluding haematolymphoid tumours) rare in adults, within top 10 paediatric cancers M>F bimodal age (10-20s, and >50)
27
osteosarcoma in adolescents
``` primary oosteosarcoma majority idiopathic hereditary retinoblastoma Li-Fraumeni syndrome (p53 mutation) ionising radiation ```
28
osteosarcoma in older adults
secondary osteosarcoma usually underlying benign bone disease - paget's diseasse, benign bone tumours, chronic osteomyelitis
29
clinical presentation of osteosacroma
local pain (nocturnal, doesnt respond to simple analgaesics) palpable mass pathological fracture constitutional symptoms (fever, anorexia, weight loss, metastatic disease)
30
prognosis of osteosarcoma
80% 5 year survival for localised disease | 30% 5 year survival for metastatic disease
31
radiological clues of osteosarcoma
codman's triangle | sunburst pattern
32
slide features of osteosarcoma
malignant tumour cells producing osteoid matrix often in delicate pericellular lacelike pattern (prominent in osteoblastic variant)
33
osteoid osteoma
benign bone forming tumour 15% of all primary bone tumours 5-20s, M:F = 2:1
34
site of osteoid osteoma
long bones (tibia/femur) within cortex
35
clinical presentation of osteoid osteoma
nocturnal pain responsive to NSAIDs
36
osteoid osteoma radiology appearance
small circumscribed cortical based lesioon trabeculae of woven bone plump osteoblastic rimming
37
enchondroma
benign intramedullary cartilagenous neoplasm
38
incidence of enchondroma
25% primary benign bone tumours | 20s-30s, M=F
39
site of enchondroma
small tubular bones of hands and feet (phalanges) > long bones
40
risk factors for enchondroma
multiple lesions in ollier's syndrome (non-inherited)
41
clinical presentations for enchondroma
asymptomatic, incidental radiological finding | pain with pathological fracture
42
prognosis of enchondroma
benign, treated with local curettage
43
imaging of enchondroma
circumscribes cartilagenous lesion expanding medullary cavity of tubular bones slide - nodules of hyaline cartilage, sharp interface with trabecular bone
44
osteochondroma
benign pedunculated tumour of bone with cartilage cap overlying bony stalk commonly called 'exostosis'
45
incicdence of osteochondroma
most common benign bone tumour | 10-20 years M>F
46
site of osteochondroma
metaphyseal surface of long bones
47
risk factors for osteochondroma
multiple hereditary exostosis | autosomal dominant
48
clinical presentation of osteochondroma
asymptomatic, usually incidental radiological finding | pain if impinging on nerve or fracture of stalk
49
prognosis of osteochondroma
benign, conservative management | symptomatic cases cured with simple excision
50
osteochondroma imaging
poedunculated lesion arising from metaphysis ponts aw2ay from joint space stalk contnuous with medullary cavity
51
osteochondroma pathology sslide
``` cartilage cap (neoplastic) merges with underlying bony stalk through enchondral ossification ```
52
fibrous dysplasia
benign fibro-osseous tumour of bone
53
incidence of fibrous dysplasia
7% of primary bone tumours | early-mid adulthood, M=F
54
site of fibrous dysplasia
axial skeleton > long bones
55
risk factors for fibrous dysplasia
polyostotic disease (McCune- Albright syndrome) - non-inherited - cafe-au-lait spots, endocrine abnoormalities
56
clinical presentation of fibroous dysplasia
most are incidental radiological findings
57
prognosis of fibrous dysplasia
benign (although low risk of malignant change)
58
fibrous dysplasia imaging
well defned ground glass opacity within medullary cavity | varus deformity in femur - 'shepard's crook'
59
fibrous dysplasia pathology slide
fibro-ossseous tumour curvilinear arrays of woven bone fibrous stroma wth bland spindle cells
60
ewing sarcoma
highly malgnant small round blue cell tumoour | primitive neuroectodermal tumour (PNET)
61
incidence of ewing sarcoma
10% of primary malignant bone tumours 10-15 years M>F
62
site of ewing sarcoma
long bones, pelvis
63
clinical presentatioon of ewing sarcoma
painfull enlarging mass | systemic symptoms with metastatic disease
64
prognoss of ewing sarcoma
5 year survival 75%, long term cure 50%
65
ewing sarcoma appearance
destructive mass within the medullary cavty of bone or ssoft tissue
66
ewing sarcoma in the microscope
prototypical small round blue cell tumour
67
malignant soft tissue tumours
sarcoma | common paediatric cancer
68
clincal presentation of soft tisue tumours
palpable mass for extremity tumours | abdominal distension for abdominal/retroperitoneal tumours
69
red flags raising suspicion for sarcomas
tumoours size >5cm or enlarging mass deap-sseated (deep to fascia, instramuscular painful multiple lesions

Pathology 3 (11 decks)

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