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Flashcards in soft tiss 2 Deck (15)
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1

Aneurysmal bone cysts

usually related to trauma, show evidence of prior hemorrhage and contain multinucleated giant cells

2

Bone Tumors

Osteosarcoma > chondrosarcoma > Ewing sarcoma

3

Benign bone tumors

Occur in adolescents, > males
Cured by local excision
Round or oval masses
Characterized morphologically by a sclerotic band of reactive bone formation around a small central core of active bone formation
Trabeculae of woven bone surrounded by osteoblasts with loose, intervening CT
May expand, erode & cause compression fractures

4

Osteoid osteomas

arise from beneath the periostium or from the involve the cortex of long bones

5

Osteoblastomas

> 2 cm in diameter, painful
Osteoblastomas typically occur in vertebral bodies

6

Osteosarcoma – Malignant Bone Tumors

-Malignant neoplasm of osteoblasts generally occurs in childhood or adolescence in the metaphysis of long bones, > males
-Characterized by osteoid formation (non-mineralized new bone)
-Can arise from Paget's disease of bone in elderly individuals
-Since tumor cells often digest & migrate through the bone cortex to lift the periosteum which is seen as a triangular shadow on X-rays referred to as Codman’s triangle

7

Giant Cell Tumor of Bone

Consist of multinucleated giant osteoclast-like cells
RANKL expressing mononuclear cells interdigitate among multinucleate giant tumors cells

8

Ewing sarcoma

Sheets of small round cells with little cytoplasm
6-10% bone tumors, second most common pediatric bone tumor 80%males

9

Tumor Metastasis to Bone

-Some tumors have a propensity to metastasize to bone (prostate cancer, clear-cell carcinoma of the kidney, and hepatocellular carcinoma)
-Breast and lung cancer metastases to (rib) bone can result in pathologic fractures

10

Diseases of Cartilage: Osteochondroma – benign tumors

-Osteochondromas are cartilage-producing, benign slow-growing tumors,
- > males, late teen-early adulthood
-Inactivation of both copies of the TS genes EXT1 or EXT2 are associated with hereditary or sporadic (autosomal dominant) disease

11

Chondrosarcoma: Malignant tumors

-Tumors of older individuals (>40 yrs, >males)
-Show extensive cartilage formation
-Appear as large, soft tissue masses with "popcorn" calcifications on x-ray

12

Osteoarthritis

-Osteoarthritis is a degenerative condition in older individuals (>50yrs)
-Age-related changes and repetitive minor joint trauma (most common joint disease)
-Osteoarthritis is thinning and erosion of articular cartilage
-In severe cases, subchondral cysts form in articular bone from leakage of synovial fluid between fractures
-Over time, microfractures develop in articular bone, resulting in more deformity and associated pain/Surgical joint replacement

13

Osteoarthritis (vs rheumatoid arthritis)

50-60 yrs age, not gender specific
Symptoms include joint pain, stiffness, crepitus (grating, cracking, popping sounds), limited mobility
Progressive degeneration without bone fusion

14

Rheumatoid Arthritis

20-40 yr, > women
Symptoms include joint pain, stiffness, limited mobility
Autoimmune disease, chronic inflammation causing synovitis
Results in bone fusion: ankylosis

15

Rheumatoid arthritis

-Untreated, RA damages articular cartilage, forms pannus (abnormal fibrovascular/granulation tissue over synovial cells on inside of joint) & causes ankylosis (joint fusion)
-Hand deformation results in "swan neck"
-Synovitis promotes synovial hyperplasia due to dense inflammatory infiltrate
-Diagnostic features: palisading histiocytes, rheumatoid factor and/or cyclic citrullinated peptide (CCP) autoantibody & altered synovial fluid