Orthopedic Pathology: Introduction Flashcards

(44 cards)

1
Q

Order of importance for AJCC staging system

A
  1. stage
  2. metastases
  3. skip lesions
  4. grade
  5. size
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2
Q

Enneking System

A

I - Low grade

II - High grade

III - Any grade with metastases

A - Intracompartmental

B - Extracompartmental

EXAMPLES : IA, IB, IIA, IIB, IIIA, IIIB

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3
Q

Low grade tumors:

BONE

A

* parosteal osteosarcoma

* primary chondrosarcoma

* secondary chondrosarcoma

* hemagioendothelioma

* chordoma

* adamantinoma

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4
Q

High grade tumors:BONE

A

* intramedullary osteosarcoma (classic)

* post-radiation sarcoma

* paget sarcoma

* fibrosarcoma

* malignant fibrous histiocytoma

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5
Q

Low grade tumors:SOFT TISSUE

A

* myxoid liposarcoma

* lipoma-like liposarcoma

* angiomatoid malignant fibrous histiocytoma

* rhabdomyosarcoma

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6
Q

High grade tumors:SOFT TISSUE

A

* malignant fibrous histiocytoma

* pleomorphic liposarcoma

* synovial sarcoma

* alveolar cell sarcoma

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7
Q

Common metastatic bone lesions:BIRTH TO 5 YEARS

A

* Leukemia

* metastatic neuroblastoma

* metastatic rhabdomyosarcoma

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8
Q

Common benign bone lesions:BIRTH TO 5 YEARS

A

* osteomyelitis

* osteofibrous dysplasia

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9
Q

Common metastatic bone lesions:10-25 YEARS

A

* osteosarcoma

* ewing tumor

* leukemia

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10
Q

Common benign bone lesions:10-25 YEARS

A

* eosinophilic granuloma

* osteomyelitis

* enchondroma

* fibrous dysplasia

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11
Q

Common metastatic bone lesions:40-80 years

A

* metastatic bone disease

* myeloma

* malignant fibrous histiocytoma

* paget sarcoma

* post-radiation sarcoma

* lymphoma

* chondrosarcoma

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12
Q

B HEMP

Common benign bone lesions:40-80 years

A

* hyperparathyroidism

* paget disease

* mastocytosis

* enchondroma

* bone infarcts

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13
Q

Most common soft tissue tumor in children?

A

Hemangioma

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14
Q

Most common soft tissue tumor in adults?

A

Lipoma

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15
Q

Most common malignant soft tissue tumor in children?

A

Rhabdomyosarcoma

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16
Q

Most common malignant soft tissue tumor in adults?

A

Malignant fibrous histiocytoma

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17
Q

Most common primary benign bone tumor?

A

Osteochondroma

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18
Q

Most common primary malignant bone tumor?

19
Q

Most common secondary benign lesion?

A

Aneurysmal bone cyst

20
Q

Most common secondary malignant lesions?

A

* Malignant fibrous histiocytoma

* Osteosarcoma

* Fibrosarcoma

21
Q

Most common phalangeal tumor?

22
Q

Most common sarcoma of hand/wrist?

A

Epithelioid sarcoma

23
Q

Most common sarcoma of the foot/ankle?

A

Synovial sarcoma

24
Q

Typical neoplasms of whole bone:TIBIA

A

* adamantinoma

* osteofibrous dysplasia

25
Typical neoplasms of whole bone:POSTERIOR CORTEX OF FEMUR
\* parosteal osteosarcoma \* pariosteal desmoid
26
Typical neoplasms of part bone:EPIPHYSIS
\* giant cell tumor (starts in the meta and works down to epi) \* chondroblastoma \* aneurysmal bone cysts \* osteomyelitis (TB, fungus)
27
Typical neoplasms of part bone:METAPHYSIS
\* metaphyseal fibrous defect \* aneurysmal bone cyst \* giant cell tumor (starts in the meta and works down to epi) \* osteosarcoma
28
Typical neoplasms of part bone:DIAPHYSIS
\* ewing sarcoma \* fibrous dysplasia \* eosinophilic granuloma (histocytosis) \* multiple myeloma
29
Tumor immunostatins:LANGERHANS CELL HISTIOCYTOSIS
S100, +CD1A
30
Tumor immunostatins:LYMPHOMA
+CD20
31
Tumor immunostatins:EWING SARCOMA
+CD99
32
Tumor immunostatins:CHORDOMA
Keratin, S100
33
Tumor immunostatins:MYELOMA
+CD138
34
Tumor immunostatins:ADAMANTINOMA
Keratin
35
What two essential criteria must be met for a limb salvage procedure?
1. local control of the lesion must be at least equal to amputation 2. the limb that has been saved must be functional
36
What are the types of surgical margins?
1. Intralesional margin - directly through tumor, 100% reoccurrence 2. Marginal margin - through reactive zone, 25-50% local reoccurrence 3. Wide margin - cuff of normal tissue, \<10% local reoccurence 4. Radical margin - entire tumor with surrounding compartment is removed
37
External beam radiation is indicated for which scenarios?
Local control of: 1. Ewing sarcoma 2. Lymphoma 3. Myeloma 4. Metastatic bone diseases
38
What are late affects of radiation therapy?
1. post-radiation sarcoms (mostly osteosarcoma, fibrosarcoma, or malignant fibrous histiocytoma) 2. late stress fractures (subtroch and diaphysis of femur MC)
39
Genetic defect: OSTEOSARCOMA
retinoblastoma tumor suppressor gene
40
Genetic defect: EWING SARCOMA
t(11,22)
41
Genetic defect: MYXOID LIPOSARCOMA
t(12,16)
42
Genetic defect: SYNOVIAL SARCOMA
t(X,18)
43
Genetic defect: MYXOID CHONDROSARCOMA
t(9,22)
44
Genetic defect: RHABDOMYOSARCOMA
t(1,13) or t(2,13)