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MSK > Pathology 2 > Flashcards

Pathology 2 Flashcards

1
Q

general biopsy advice?

A

more tissue the better

if its a large mass, you need a larger sample

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2
Q

when might fresh tissue be used as samples?

A

soft tissue lesions with specific genetic abnormalities (e.g leukaemias etc)

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3
Q

how are fresh tissue samples used?

A 
Cytogenic Studies
tissue placed in culture medium and cells grown fresh
karyotyping
FISH
molecular genetic studies
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4
Q

function of karyotyping?

A

gives overview of chromosomal culture

not good for small lesions

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5
Q

functions of FISH?

A

good for known translocations

paints relevant small area of chromosomes to show where it is

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6
Q

give 3 examples of a benign lesion?

A 
ganglion cyst
giant cell tumour
fibromatosis
fibrous dysplasia (rare)
fibrous cortical dysplasia (rare)
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7
Q

what is a ganglion cyst?

A

lump - usually peripheral and near joint capsule or tendon sheath(common around wrist)

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8
Q

what causes a ganglion cyst?

A

degenerative change within connective tissue

- not a true cyst as no epithelial lining

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9
Q

what does ganglion look like on histology?

A

space with myxoid material

secondary inflammatory changes

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10
Q

name 4 superficial fibromatoses

A

dupuytrens
knuckle pads
plantar
penile - peyronie’s

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11
Q

what causes fibromatoses?

A

fibrous overgrowth of dermal and subcutaneous tissue

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12
Q

fibromatoses histology?

A

spindle lesion in background of pink tissue

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13
Q

who are dupuytrens common in?

A

males>females
>60
alcohol
can be ideopathic

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14
Q

what are deep fibromatoses?

A 
different disease
mesenteric or pelvic
e.g
- desmoid tumours
- assoc with Gardner's syndrome
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15
Q

what are giant cell tumours?

A

uncommon tumour of bone characterised by multinucleate giant cells
- benign?

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16
Q

what are the 3 types of giant cell tumour?

A

pigmented villonodular synovitis
giant cell tumour of tendon sheath - digits
giant cell tumour of bone
- both benign

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17
Q

what is pigmented villonodular synovitis?

A

benign tumour of synovium in joints

- type of giant cell tumour?

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18
Q

giant cell histology?

A

hemosiderin stained, multinucleate giant cells
foam cells
highly vascularised

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19
Q

how are giant cell tumours treated?

A 
tendon = small nodules - easily excised
PVNS = more destructive and diffuse n joint space - difficult to excise and can recur
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20
Q

what does a lipoma look like on histology?

A

resembles normal fat tissue

nuclei are small and at the edge

21
Q

what are some types of lipoma?

A 
fibro
angio
spindle cell
pleomorphic
atypical
- more unusual cell form
22
Q

atypical lipoma?

A

mature fat with scattered bigger cells with atypical nuclei (lipoblasts)

  • atypical lipoma if superficial (unlikely to metastasise)
  • if retroperitoneal space = lipoma like liposarcoma
23
Q

what do angiolipoma look like?

A

often painful
vascular with fibrin trombi
usually multiple and peripheral

24
Q

causes of tender lumps? (ANGEL)

A 
Angiolipoma
Neuroma (traumatic)
Glomus tumour (nail beds)
Eccrine spiradenoma skin adnexal)
Cutaneous leiomyoma (erector pilae)
25
Q

liposarcoma histology?

A

lots of lipoblasts

26
Q

what is a leiomyoma?

A

tumour of smooth muscle

most common tumour in body (esp. uterus)

27
Q

spindle cells in pink matrix
disorganised
come atypical cells

A

possible malignancy

28
Q

what is IHC?

A

immunohistochemistry
looks for particular proteins
can be used to determine what tissue a tumour is derived from(e.g leiomyosarcoma = lots of actin etc)

29
Q

rhabdomyomas?

A

benign tumours of skeletal muscle
very rare
can occur in heart in children

30
Q

name 3 types of rhabdomyoma

A

embryonal rhabdomyosarcoma (children)
Alveolar (young adults)
Pleomorphic (older)

31
Q

rhabdomyosarcoma histology?

A

rhabdomyoblasts

32
Q

chondroma vs enchondroma?

A 
chondroma = benign cartilage tumour (common)
enchondroma = in digits (rare)
33
Q

tumour arising in the axial skeleton in older person most likely to be?

A

chondrosarcoma

don’t really affect children

34
Q

chondrosarcoma red flag?

A

tumour in axial skeleton

35
Q

tumour with basically normal cells in periphery/axial?

A 
peripheral = probably benign
axial = probably malignant
36
Q

benign bone lesion?

A

simple osteoma (often in cranial bones)

37
Q

multiple benign bone lesions?

A

gardner’s syndrome

38
Q

what is an osteoid osteoma?

A

bone tumour producing osteoid (mature bone)

sclerotic rim

39
Q

where do osteosarcomas usually occur?

A

more common in paediatric group

in long bones

40
Q

what indicates an osteosarcoma?

A

Codman’s triangle on radiology

any malignant tumour that produces osteoid = osteosarcoma until proven otherwise

41
Q

where is an osteosarcoma likely to spread?

A

lung fields

- where vascular drainage goes

42
Q

what is a Ewing’s sarcoma?

A

small, round blue cell tumour of unknown histogenesis
destructive, rapidly growing and highly malignant
often affects soft tissue/bones in children and adolescents

43
Q

what is the most common type of cancer in adults?

A

carcinoma

44
Q

features of sarcomatoid carcinomas?

A

have properties of both carcinoma and sarcoma

45
Q

what is a pseudosarcoma?

A

benign condition that can mimic sarcoma

- e.g tissues undergoing repair as they appear atypical

46
Q

reactive lesions?

A

smallish rapidly growing lesions which can be preceded by trauma
e.g nodular fasciitis, myositis ossificans

47
Q

what is nodular fasciitis?

A

reactive lesion
chaotic appearance with large atypical cells and frequent normal mitoses
haemorrhage common

48
Q

what is myositis ossificans?

A

reactive lesion
like nodular fasciitis which often occurs in large muscles
preceding trauma

MSK (66 decks)

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