Flashcards in Primary Malignancies Deck (58)
What is the most common primary malignancy?
MM (27%) (then osteosarcoma then chondrosarcoma then Ewing's)
Which primary malignancy is a proliferation of plasma cells which infiltrate the bone marrow?
What is the age range for MM?
5-8th decade (75% are of ages 50-70 years)
Which gender is more likely to have MM?
Which is more common: MM or metastasis?
Which two bone tumors are the only ones that are more common in females compared to males?
Hemangiomas and aneurysmal bone cyst ("bloody ones")
What is the most common cause of death in patients with MM?
Recurrently bacterial infections
What is the primary rad finding for MM?
Deossification of bone
What is the usual presentation of a bone scan in those with MM?
What are some laboratory findings that can be seen with MM?
Elevated ESR, plasma proteins, serum calcium, and serum phosphorus with thrombocytopenia, and rouleaux formation
What is the rouleaux formation that is commonly seen with MM?
Stacks or aggregates of RBCs seen on blood smear
What protein finding is commonly seen in 80-90% of those with MM?
Protein electrophoresis with "M-spike"
Detection of which protein in the urine can be found in 40% of MM patients?
Bence Jones proteins
What is the best test for MM besides the obvious biopsy?
M-spike protein electrophoresis
What are the common locations for a solitary plasmacytoma?
Vertebra > pelvis > skull > sternum > ribs
What is the term for a tumor that is a localized form of plasma cell proliferation?
How does a solitary plasmacytoma typically present?
Soap bubbly, highly expansile lesion
What is unique about the expansion of a solitary plasmacytoma in what it chooses to spare?
Posterior elements (of vertebrae)
What radiographic sign on an PA chest film can indicate a possible solitary plasmacytoma?
What is an extrapleural sign?
Something in the pleural space pushing lungs inward
What type of thoracic spine change can be seen with solitary plasmacytomas of multiple levels?
What is the Gibbus formation?
Acute angular kyphotic thoracic spine changes causing wedges (think multiple solitary plasmacytomas)
"Rain drop skull" is associated with which neoplasm?
What is the best imaging used to detect MM?
How can an MRI help detect MM?
Marrow changes (2nd best test)
What is the cause of the appearance of a "rain drop skull" seen with MM?
Multiple holes of various sizes in the skull
In only what specific location of the body is cortical thinning considered a normal pattern of aging?
Deltoid tuberosity of the humerus
What type of MRI is best to be used for MM detection?
STIR (contrast enhanced T1)
What is usually the prognosis for MM?
Poor (5 year survival 20%)