Neoplastic pathology

Question 1

What genetic techniques can be employed on fresh tissue?

Answer 1

Karyotyping

FISH

Question 2

How is karyotyping carried out?

Answer 2

Culture cells and then arrest during cell division

Useful for an over-view of chrosomal structure but will not detect smal lesions

Question 3

What is FISH useful for?

Answer 3

For known translocations
Can paint the relevant small area of chromosomes
Performed on fixed tissue

Question 4

What is immunohistochemistry used for?

Answer 4

To determine if a protein is present - place a pigment on an antibody to the target protein and any pigment staning left means the protein is present

Question 5

What are some common benign lesions?

Answer 5

Ganglion cyst
Giant cell tumour
Fibromatosis

Question 6

What are some rare benign lesions?

Answer 6

Fibrous cortical defect

Fibrous dysplasia

Question 7

What is a ganglion cyst?

Answer 7

Peripheral lump near a joint capsule or tendon sheath - common around wrist
Not a true cyst - no epithelial linning

Question 8

What does a ganglion cyst look like histologically?

Answer 8

Space with myxoid material. Secondary inflammatory changes

Question 9

What are some examples of superfiical fibromatosises?

Answer 9

Duptryen’s contracture
Knuckle pads
Plantar
Penile - peryonie’s

Question 10

What are some examples of deep fibromatoses?

Answer 10

Mesenteric or pelvic
Desmoid tumours
Associcated with FAP

Question 11

What are giant cell tumours?

Answer 11

Pigmented villonodular synovitis (PVNS) - large joints

Giant celll tumour of tendon sheath (GCTS) - digits

Question 12

What is the difference between GCTS and PVNS

Answer 12

GCTS is small nodules that are easily excised

PVNS are more destructive and diffuse in a joint space

Question 13

Where do angiolipomas commonly occur?

Answer 13

Multiple and peripheral

Vascular with fibrin thrombi

Question 14

What are the lesions that cause pain?

Answer 14

ANGEL:
Angiolipoma
Neuroma (traumatic)
Glomous tumour (nail beds)
Eccrine spiradenoma
Leiomyoma (cutaneous)

Question 15

What molecular test can be done to detect a leiomyoma or leiomyosarcoma?

Answer 15

IHC to detect actin, desmin or caldesmon

Question 16

What is the malignant tumour of skeletal muscle called?

Answer 16

Rhabdomyosarcoma

Question 17

Who is likely to get a cardiac rhabdomyoma?

Answer 17

Paedeatric

Question 18

What are the different types of rhabdomyosarcoma?

Answer 18

Embryonal
Alveolar
Pleomorphic

Question 19

What are the common tumours of cartilage?

Answer 19

Enchondroma

Chondromyxoid fibroma

Question 20

Where is enchondroma commonly found?

Answer 20

Digits

Can be part of ollier’s or maffuci syndrome

Question 21

Who is the sarcoma of cartilage likely to affect?

Answer 21

40s/50s

Affects axial skeleton and H&N

Question 22

What are the different types of benign bone tumours?

Answer 22

Osteoma
Gardner’s syndrome
Osteoid osteoma
Osteoblastoma

Question 23

What is the most common malignant bone tumour?

Answer 23

Osteosarcoma - paeds, affects knees and commonly spreads to lungs

Question 24

How can an osteosarcoma be diagnosed radiologically?

Answer 24

Codman’s triangle - the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone

Question 25

What are the different types of malignant bone tumours?

Answer 25

Osteosarcoma Ewing's sarcoma Synovial sarcoma

Question 26

Who does ewing's sarcoma affect?

Answer 26

Children and adolescents

Question 27

Where will ewings sarcoma present?

Answer 27

Any soft tissue or bony location but commonly long bones | Destructive, rapipdly growing and highly malignant

Question 28

What type of cell does ewing's sarcoma originate from?

Answer 28

Primitive mesenchymal or neuroectdermal cell

Question 29

What genetic abnormalities are associted with ewing's sarcoma?

Answer 29

t(11;22)

Question 30

What is a pseudosarcoma?

Answer 30

Tissues undergoing repiar often appear very atypical and the diagnosis can be very difficult

Question 31

What is nodular fascitis?

Answer 31

Any age group, rapid growth | History of preceeding trauma

Question 32

What does nodular fasciitis look like histologically?

Answer 32

``` Very chaotic appearance Haemorrhage Pseudocystic spaces Large, atypical cells Frequent mitoses ```

Question 33

What is myositis ossificans?

Answer 33

Affects big muscles - quadriceps, gluteus

Question 34

What autoantibodies with scleroderma show?

Answer 34

Diffuse anti-scl-70 | Anti-centromere

Question 35

What autoantibodies witll sjogrens show?

Answer 35

Anti Ro La

Question 36

What will dermatomyositis show?

Answer 36

Anti Jo

Question 37

What will amyloidosis look like histologically?

Answer 37

Apple green birefringence with congo red staining

Question 38

What antibodies will RA produce?

Answer 38

Rheumatoid factor | IgM

Question 39

What will occur to the joint space in RA?

Answer 39

Cartilage is destroyed Pannus formation - inflammatory cells, hyperplastic synovium IgM mediated so many IgM cells