Pathology 2

Question 1

general biopsy advice?

Answer 1

more tissue the better

if its a large mass, you need a larger sample

Question 2

when might fresh tissue be used as samples?

Answer 2

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

Question 3

how are fresh tissue samples used?

Answer 3

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

Question 4

function of karyotyping?

Answer 4

gives overview of chromosomal culture

not good for small lesions

Question 5

functions of FISH?

Answer 5

good for known translocations

paints relevant small area of chromosomes to show where it is

Question 6

give 3 examples of a benign lesion?

Answer 6

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

Question 7

what is a ganglion cyst?

Answer 7

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

Question 8

what causes a ganglion cyst?

Answer 8

degenerative change within connective tissue

- not a true cyst as no epithelial lining

Question 9

what does ganglion look like on histology?

Answer 9

space with myxoid material

secondary inflammatory changes

Question 10

name 4 superficial fibromatoses

Answer 10

dupuytrens
knuckle pads
plantar
penile - peyronie’s

Question 11

what causes fibromatoses?

Answer 11

fibrous overgrowth of dermal and subcutaneous tissue

Question 12

fibromatoses histology?

Answer 12

spindle lesion in background of pink tissue

Question 13

who are dupuytrens common in?

Answer 13

males>females
>60
alcohol
can be ideopathic

Question 14

what are deep fibromatoses?

Answer 14

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

Question 15

what are giant cell tumours?

Answer 15

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

Question 16

what are the 3 types of giant cell tumour?

Answer 16

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

Question 17

what is pigmented villonodular synovitis?

Answer 17

benign tumour of synovium in joints

- type of giant cell tumour?

Question 18

giant cell histology?

Answer 18

hemosiderin stained, multinucleate giant cells
foam cells
highly vascularised

Question 19

how are giant cell tumours treated?

Answer 19

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

Question 20

what does a lipoma look like on histology?

Answer 20

resembles normal fat tissue

nuclei are small and at the edge

Question 21

what are some types of lipoma?

Answer 21

fibro
angio
spindle cell
pleomorphic
atypical
- more unusual cell form

Question 22

atypical lipoma?

Answer 22

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

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

Question 23

what do angiolipoma look like?

Answer 23

often painful
vascular with fibrin trombi
usually multiple and peripheral

Question 24

causes of tender lumps? (ANGEL)

Answer 24

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

Question 25

liposarcoma histology?

Answer 25

lots of lipoblasts

Question 26

what is a leiomyoma?

Answer 26

tumour of smooth muscle | most common tumour in body (esp. uterus)

Question 27

spindle cells in pink matrix disorganised come atypical cells

Answer 27

possible malignancy

Question 28

what is IHC?

Answer 28

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

Question 29

rhabdomyomas?

Answer 29

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

Question 30

name 3 types of rhabdomyoma

Answer 30

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

Question 31

rhabdomyosarcoma histology?

Answer 31

rhabdomyoblasts

Question 32

chondroma vs enchondroma?

Answer 32

``` chondroma = benign cartilage tumour (common) enchondroma = in digits (rare) ```

Question 33

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

Answer 33

chondrosarcoma | don't really affect children

Question 34

chondrosarcoma red flag?

Answer 34

tumour in axial skeleton

Question 35

tumour with basically normal cells in periphery/axial?

Answer 35

``` peripheral = probably benign axial = probably malignant ```

Question 36

benign bone lesion?

Answer 36

simple osteoma (often in cranial bones)

Question 37

multiple benign bone lesions?

Answer 37

gardner's syndrome

Question 38

what is an osteoid osteoma?

Answer 38

bone tumour producing osteoid (mature bone) | sclerotic rim

Question 39

where do osteosarcomas usually occur?

Answer 39

more common in paediatric group | in long bones

Question 40

what indicates an osteosarcoma?

Answer 40

Codman's triangle on radiology | any malignant tumour that produces osteoid = osteosarcoma until proven otherwise

Question 41

where is an osteosarcoma likely to spread?

Answer 41

lung fields | - where vascular drainage goes

Question 42

what is a Ewing's sarcoma?

Answer 42

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

Question 43

what is the most common type of cancer in adults?

Answer 43

carcinoma

Question 44

features of sarcomatoid carcinomas?

Answer 44

have properties of both carcinoma and sarcoma

Question 45

what is a pseudosarcoma?

Answer 45

benign condition that can mimic sarcoma | - e.g tissues undergoing repair as they appear atypical

Question 46

reactive lesions?

Answer 46

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

Question 47

what is nodular fasciitis?

Answer 47

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

Question 48

what is myositis ossificans?

Answer 48

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