8: Bone, cartiledge, soft tissue tumors Flashcards
Staging of Bone Lesion
• X-ray of entire affected bone
• Whole body bone scan (or skeletal
survey)
• CT scan of chest, abdomen, and
pelvis OR or PET/CT
• Serum Protein Electrophoresis /Urine
Protein Electrophoresis /serum free
light chains
(for multiple myeloma or
plasmacytoma)
• Prostatic specific antigen (for prostate carcinoma
A common lymphoid malignancy
(Sheets of plasma cells with atypical
cell features)
Median age is 70 years
Principally involves bone marrow
and causes lytic lesions throughout
skeleton (most commonly vertebrae, ribs,
skull, pelvis, femur, clavicle, & scapula)
Multiple Myeloma
Principally involves bone marrow
and causes lytic lesions throughout
skeleton (most commonly vertebrae, ribs,
skull, pelvis, femur, clavicle, & scapula)
Multiple myeloma
Cells produce monoclonal immunoglobulin IgG and results in pathologic fx
Multiple Myeloma
neoplasms composed
of lymphocytes resembling a normal
stage of differentiation
Lymphomas:
B-cell lymphomas: most common
type of lymphoma in adults, derived
from clonal B cells
most common
type of lymphoma in adults, derived
from clonal B cells
B-cell lymphomas:
Histlolgically, how can we idenfity B cell lymphomas
CD20 marker
Most common cancer in nonsmoking women
Lung adenocarcinomas:
Metastases early (to bone, brain,
and liver)
Lung adenocarcinomas met early to:
Lung adenocarcinomas:
Metastases early (to bone, brain,
and liver)
Performed biopsy from cancer in stomach. Stains TTF1 +… What does this mean
Means it is lung adenocarcinma origin… this is not the primary tumor- its inthe lung
Location of Unicameral Bone cyst
Who it affects
Bone Cyst
- Benign
- Children & young adults
- Metaphyseal region of long bones
- Usually proximal femur or humerus
10 yo male comes in with lesion in his humerus. Has periosteal rxn and soft tissue invovlment with abnormal bone marrow. DDx?
Osteosarcoma
Ewing Sarcoma
Presentaiton of Unicarmeral Bone Cyst
-Presentation: pathologic fracture
-Bone cortex is eroded by cyst & elicits
secondary periosteal new bone
formation
Pathology: cyst filled with clear fluid &
lined with thin fibrous membrane
-Because of frequent fractures: old blood
(hemosiderin) and granulation tissue
maybe present
Unicameral Bone Cyst
You are doing a pathology rotation and the attending shows you a A spongy, honeycombed, blood-filled mass with cystic
spaces of various sizes, some containing osseous
tissue within the septated walls.
Aneurysmal Bone Cyst
Histology of ABC tumor
Giant cell, immature bone, &
blood filled cysts without lining
cells
Descibe the lesion in ABC and who is likely to get it and why they would come to clinic
Eccentric solitary expansile lesion
- Mostly < 20 years
- Swelling, pain, or tenderness
MOst common invovlement (part of bone and location) of ABC
- Metaphyseal region of long bones: common
- -But any bone may be involved
Pathology of ABC
bening neoplasm with characteristic translocation
TX for ABC
Curettate, embolaization and scleropahty
See a lytic lesion with no mineral in it, going up into epiphysis. May have soft tissue invovlment
Giant Cell TUmor
Adult Soft Tissue Masses:
Lipomas
• Soft tissue sarcomas
• Desmoid fibromatosis
What kind of tumor is this… What are the key characteristics?
LIpoma
see bening looking lipoblasts
When removing this tumor it is well encased and comes right out
Lipomas
Desmoid Fibromatosis histology
What special staining can we use
bland spindle cells, densely packed, no pleomorphism.
Stain with Beta Catenin
