2.3 Bone and Tumor Pathology

Question 1

expansile lesion with ground glass appearance on Xray, diffuse mineralization, common in early adolescence, positive bone scan; curvilinear trebeculae of woven bone, lack osteoblastic rimming, fibrous background

Answer 1

fibrous dysplasia

Question 2

benign tumor of osteoblasts (that produce osteoid) surrounded by a rim of reactive bone

Answer 2

osteoid osteoma

Question 3

Osteoid osteoma arises in _____ of long bones (femur), presents as bone pain that resolves with ______

Answer 3

cortex, aspirin

Question 4

imaging reveals a bony mass (<2 cm) with a radiolucent core (osteoid), occurs in teens and early 20s

Answer 4

osteoid osteoma

Question 5

larger (>2cm), arises in vertebrae, and presents as bone pain that does not respond to aspirin

Answer 5

osteoblastoma

Question 6

osteoid osteoma is painful because of excess _________ produced by proliferating osteoblasts, relieved by aspirin

Answer 6

prostaglandin E2

Question 7

Giant cell tumors are composed of ___________ and ________ cells

Answer 7

multinucleated giant cells, stromal cells

Question 8

Giant cell tumors arises in the ________ of long bones, usually the distal femur or proximal tibia

Answer 8

epiphysis

Question 9

Giant cell tumors give a ________ appearance on Xray

Answer 9

soap bubble

Question 10

tumor of bone with overlying cartilage cap (exostosis), most common benign tumor of bone, hereditary

Answer 10

osteochondroma

Question 11

osteochondroma arises from a lateral projection of the _______, bone is continuous with the marrow space

Answer 11

growth plate (metaphysis)

Question 12

in osteochondroma the overlying cartilage can (rarely) transform to ________

Answer 12

chondrosarcoma

Question 13

malignant cartilage forming tumor, arises in medulla of pelvis or central skeleton

Answer 13

chondrosarcoma

Question 14

arise in metaphyseal region, usually hands and feet, benign tumor of cartilage

Answer 14

enchondroma

Question 15

Multinucleated giant cells express _________ in giant cell tumors

Answer 15

RANK-L

Question 16

• autosomal dominant
• exophytic(cauliflower) stalk with medullary canal with bursitis
• EXT gene in chondrocytes
• exostosis: benign cartilage capped outgrowth attached to skeleton by bony stalk

Answer 16

osteochondromatosis

Question 17

multiple enchondromas, occur in metaphyseal region of bone, commonly on hands and feet, pink/blue matrix, not very cellular

Answer 17

Ollier’s Disease