MSK path VIII Flashcards Preview

Year2 MSK exam 1 > MSK path VIII > Flashcards

Flashcards in MSK path VIII Deck (42)
1

Giant cell tumor

multinucleated osteoclast type giant cells "osteoclastoma"
benign, locally aggressive
20-40 y.o

2

where do giant cell tumors of bone grow

epiphyseal tumor

3

Cx in giant cell tumor

destroyed from buldging red brown mass with cystic degeneration

4

soap bubble tumor

giant cell tumor

5

Tx giant cell tumors

curettage

6

mets of giant cell tumors

lungs

7

what drug is effective in giant cell tumors

RANKL inhibitor denosumab

8

aneurysmal bone cyst

tumor characterized by multiloculated blood filled cystic spaces

9

where do primary anerysmal bone cysts occur

first 2 decades life in metaphysis of long bones
posterior elements of vertebral bodies

10

common signs and Sx aneurysmal bone cysts

pain and swelling

11

on radiograph see eccentric expansile lesion with well defined margins, msot lytic and have thin shell reactive bone at periphery
CT and MRI show internal septa and fluid fluid levels

aneurysmal bone cyst!!

12

describe cysts in ABC

blood filled spaces with tan white thin septae between

13

"blue bone" calcified matrix

aneurysmal bone cyst ABC

14

Tx ABC

surgical curettage or en bloc resection

15

fibrous cortical defects

metaphyseal fibrous defects
common in children >2 y.o

16

where do fibrous cortical defects arise

eccentrically metaphysis distal femur and proximal tibia
almost half b/l or multiple

17

what is it called when fibrous cortical defect is 5-6 cm

nonossifying fibroma (not detected until adolescence or adulthood)

18

sharply demarcated radiolucencies with long axis of bone parallel to Cx
thin rim sclerosis
yellow brown cellular lesions with fibroblases and macrophages
storiform (pinwheel) formation
foamy cytoplasm

fibrous cortical defect and nonossifying fibroma

19

clinical course fibrous cortical defects

spontaneous resolution within several years

20

presentaiton of nonossifying fibroma

pathologic fracture that needs Bx and curettage

21

what is fibrous dysplasia

benign tumor
arise during skeletal development

22

monostatic fibrous dysplasia

involve one bone

23

polyostatic fibrous dysplasia

involve many bones

24

mazabraud syndrome

fibrous dysplasia and soft tissue myzomas

25

McCune Albright syndrome

polyostotic disease
cafe au lait skin pigmentation
endocrine abnormalities
precocious puberty!

26

"ground glass metaphysis"

fibrous dysplasia

27

morphology of fibrous dysplasia

well circumscribe, intramedullary
if large can distort bone
tan white and gritty with curvilinear trabeculae of woven bon surrounded by fibroblastic proliferation

28

what tumor mimics chinese characters

fibrous dysplasia

29

when does monostotic fibrous dysplasia occur

boys and girls early adolescence
usually stops growing when growth plate closes

30

bones commonly affected by monostotic fibrous dysplasia

femur, tibia, jawbones, calvarium and humerus

31

clinical presentation fiborus monostotic dysplasia

incidentally found
may cause pain, fracture and discrepencies in leg length

32

bones affected in polyostotic fibrous dysplasia

vertebrae, mandible, ulna radius, fibula, ribs, humerus, tibia, skull, femur

33

craniofacial involvemtn with fibrous dysplasia is seen when

when extensive skeletal disease

34

Tx fibrous dysplasia

orthropedic surgical procedures
bisphosphonates

35

can severe fibrous dysplasia transform

yes to osteosarcoma

36

ways of metastatic tumors to bone

direct extension, lymphatic or hematogenous dissemination, intraspinal seeding via batson plexus of veins

37

75% skeletal mets come from CA where

prostate, breast, kidney lung

38

radiographic appearance of mets tumors

lytic, blastic, mixed

39

prostatic adenoca mets to bone causes what

blastic lesions

40

carcinomas of kidney lung and GI and malignant melanoma cause what type lesions in bone

lytic

41

most likely CA to mets

prostate, breast, kidney, thyroid lung

42

what type of mutations occur in fibrous cortical defect and fibrous dysplasia

gain of function during development