2.1.3 Bone and Tumor Pathology I Flashcards
What are some of the tools for evaluating a bone lesion?
H&P, plain films, MRI, CT, and bone scan
Diagnose me.
Monostatic fibrous dysplasia
What is the size of the nidus in osteoid osteoma?
under 2 cm
diagnose me.
Giant cell tumor
What is the reason for pain in osteoid osteoma?
Prostaglandins are being made in the lesion. That is why aspirin is particularly useful in reducing the nighttime pain experienced in these patients.
Name this condition?
Osteoid osteoma
What is the name for the condition for multiple enchondromas?
Oillier’s dz
What is being shown here on this bone scan of a 10-year old girl with monostatic fibrous dysplasia?
B/c the girl is still growing, the areas of the metaphysis are still lighting up b/c of their metabolic activity. In hip, there is assymetric activity which is indicative of an active lesion.
What are the three clinical patterns of fibrous dysplasia?
Monostotic (70%) - early adolescence
Polyostotic (27%)
Polystotic dz, assoc w cafe au lait skin pigmentation and endrocrine abnormalities (McCune-Albright syndrome)
What type of radiological study is good for viewing osteoid osteoma?
CT
Benign cartilage-capped outgrowth that is attached to the skeleton by a bony stalk
Exostosis
What is true about the activity of most tumors in upper extremities?
More active
What is the shepard’s crook deformity?
The bowing of the diaphysis in relation to the head. Doing this because the bone is weak and their is an adductor moment in the hip.
Id this specifmen
Osteochondroma
Condition?
Giant cell tumor
What is the saying about biopsies and cultures regarding bone?
Culture every biopsy
Biopsy every culture
What is the most common benign lesion within the diaphysis region of the bone?
Osteoid osteoma
What is this condition?
Enchondromas
Middle-aged female with epiphyseal lesion.
(Primarly in the epiphysis that has crossed the metaphysis, distinct borders, started in medullary canal and expanded into the cortex. Edges of bone are very thin)
Giant cell tumor
What are the three types of lesions found in the epiphysis and the common age group?
Infection - kids
Chondroblastoma - adolescents
Giant cell tumor - usually adults
What protein is mutated in McCune-Albright syndome?
Guanine nucleotide-binding protein (G protein)
condition?
Giant cell tumor
Nuclei in background look the same as the nuclei in the aggressive large osteoclasts. Also, the osteoclasts have an increased number of nuclei
What are some other features seen on this path slide? What condition?
Cs and Js of osteoid; Background of spindle-shaped cells with elongated or truncated nuclei (depending on cut)
Monostatic fibrous dysplasia
What temporality of pain for kids and adults is most concerning?
Night pain (something bad until you can prove it something else)
Condition?
(hint: AD inheritence)
Hereditary, multiple osteochondromatosis
What is covered?
Nidus
In center, you can see the lesion - fibrovascular structure. Around the lesion, there is a thick layer of reactive bone.
What are these light brown macules?
Cafe au lait spots
What is the current treatment for osteoid osteomas?
aspirin
RFA - radio-frequency ablation - cut a hole into the bone, drop a radio probe into the bone, heat it up with radio waves (can’t do this in the spine)
When do most all of the lesions present by in patients with osteochondromas?
by age 12, patient typically has had enough growth spurts
If the pain from this type of lesion (osteoid osteoma) is controlled, what are the steps in txt of this patient?
Continue txt w/ anti-inflammatory drugs. Studies show that some of these burn out after 3 yrs and stop hurting.
condition?
Giant cell tumor
What is the another name for multiple hereditary exostosis?
Multiple osteochondromas
Txt for giant cell tumor?
Surgrical resection - although benign, these are are locally aggressive
Denosumab (used in osteoporosis) - targets the cells that are chewing up bones
If you’re looking for a tumor in the cortex, is a MRI of good use?
No, there isn’t much fluid/soft tissue in the cortex
Describe the appearence on this plain film.
Lesion is in the diaphysis (top/bottom), the cortex (inside/out), narrow zone of transition, bone reaction -making bone around it w/ a smooth external surface - meaning it isn’t make bone really fast
