8.) Introduction to Tumor Classification

Question 1

What are the 5 benign bone tumors?

Answer 1

1. ) Osteoid osteoma
2. ) Osteoblastoma
3. ) Osteoma
4. ) Osteoclastoma (Giant Cell)
5. ) Bone Island

Question 2

What is the malignant bone tumor?

Answer 2

Osteosarcoma

Question 3

What are the 4 benign cartilagenous tumors?

Answer 3

1. ) Enchondroma
2. ) Chondroblastoma
3. ) Osteochondroma
4. ) Chondromyxoid fibroma

Question 4

What is the malignant cartilagenous tumor?

Answer 4

Chondrosarcoma

Question 5

Where do vascular bone tumors come from?

Answer 5

Vessels and blood cell lines

Question 6

What are the 2 vascular bone tumors?

Answer 6

1. ) Hemangioma

2. ) Aneurysmal bone cyst

Question 7

What are 3 examples of malignant blood transporting or blood forming elements?

Answer 7

1. ) Ewing’s tumor
2. ) Myeloma
3. ) Lymphoma/Leukemia

Question 8

What are 3 examples of benign fibrous bone tumors?

Answer 8

1. ) Paget’s disease
2. ) Fibrous dysplasia
3. ) Fibroxanthomas

Question 9

What are 2 examples from the notes of fibroxanthomas?

Answer 9

1. ) Non-ossifying fibroma

2. ) Benign fibrous cortical defect

Question 10

What are 2 examples of malignant fibrous bone tumors?

Answer 10

1. ) Fibrosarcoma

2. ) Malignant fibrous histiocytoma

Question 11

What is an example of a fluid filled cystic lesion?

Answer 11

Unicameral bone cyst

Question 12

What makes up an aneurysmal bone cyst?

Answer 12

Vascular channels containing flowing blood, but looks cystic

Question 13

What are 2 examples of cystic-looking, but not fluid filled lesions?

Answer 13

1. ) Intraosseous lipoma

2. ) Giant cell tumor

Question 14

What is an intraosseous lipoma filled with?

Answer 14

Fat

Question 15

What are 3 characteristics of giant cell tumors?

Answer 15

1. ) Looks “empty”
2. ) Develops from non-bone connective tissue
3. ) Spindle-shaped stromal cells

Question 16

Are most tumor and tumor-like lesion of bone malignant or benign?

Answer 16

Benign

Question 17

Are most malignant bone lesions primary or secondary??

Answer 17

Secondary (i.e. metastatic)

Question 18

What is the most common primary malignancy of adult bone and the spine?

Answer 18

Multiple myeloma

Question 19

Most metastatic lesions to bone arise from what 4 primary sites?

Answer 19

1. ) Breast
2. ) Prostate
3. ) Kidney
4. ) Lung

Question 20

Where are most metastatic bone lesions located in the skeleton?

Answer 20

Axial skeleton

Question 21

Where are most metastatic bone lesions rarely located?

Answer 21

Distal to the elbows or knees

Question 22

What is the term for a primary malignancy of connective tissue origin?

Answer 22

Sarcoma

Question 23

What is a geographic pattern of destruction?

Answer 23

A focal area of well-localized destruction with complete border and clearly defined margins between the lesion and adjacent normal bone?

Question 24

What is permeative pattern of destruction?

Answer 24

Destruction of local area with many tiny lytic lesions centrally and gradually fewer and fewer peripherally, fading into more normal bone

Question 25

What is the aka for the moth-eaten pattern of destruction?

Answer 25

Punched-out

Question 26

What is moth-eaten (punched-out) pattern of destruction?

Answer 26

Multiple larger destructive areas with poorly defined margins and cortical destruction

Question 27

Are a majority of metastatic lesions to the skeleton lytic or blastic?

Answer 27

Lytic

Question 28

What are the 2 tumor-like disorders of bone that are sometimes referred to as the "great imitators" of bone disease?

Answer 28

1. ) Paget's disease | 2. ) Fibrous dysplasia

Question 29

What is the most common location for tumors that occur in long bones?

Answer 29

Metaphysis

Question 30

Geographic lesions that expand the cortex are more commonly associated with what type of histology?

Answer 30

Benign

Question 31

Permeative and Moth-eaten patterns are more commonly associated with what type of histology?

Answer 31

Malignant or aggressive

Question 32

What neoplastic disease is often aggressive?

Answer 32

Infection

Question 33

What is the matrix?

Answer 33

The "internal architecture" of lesions

Question 34

Popcorn or "rings/broken rings" of calcification often implies what type of tissue?

Answer 34

Cartilage

Question 35

Solid, homogenously dense calcification implies what type of tissue?

Answer 35

Bone

Question 36

What is an example from the notes of a "friendly" bone lesion?

Answer 36

Bone island

Question 37

What would be 2 possible diagnoses of multiple bones with sclerotic lesions in an older patient?

Answer 37

1. ) Blastic metastatic disease | 2. ) Paget's disease

Question 38

What are 3 characteristics of Paget's disease?

Answer 38

1. ) Bone expansion 2. ) Cortical thickening 3. ) Coarse trabeculae

Question 39

Solid, well organized bone tissue may be seen with what bone tumor?

Answer 39

Osteochondroma

Question 40

What causes an osteochondroma to be likely chronic and therefore benign?

Answer 40

Pressure deformity of adjoining bone

Question 41

Some matrix patterns are very characteristic when seen in classic locations. What is the matrix pattern commonly seen in the vertebral bodies in hemangiomas?

Answer 41

Corduroy stripe

Question 42

Corduroy stripe is commonly seen with what diagnosis?

Answer 42

Hemangioma

Question 43

Where are hemangiomas commonly discovered?

Answer 43

On MR exams as incidental findings

Question 44

What are 3 of the most common "empty" looking lesions?

Answer 44

1. ) Largely fluid (blood, serous) 2. ) Low density tissue (fat-lipoma, non-calcified tissues-giant cell tumor) 3. ) Mets (little internal architecture)

Question 45

What are 5 things that identify a benign lesion?

Answer 45

1. ) Pattern of bone destruction: Geographic 2. ) Cortex: Expanded, but not destroyed 3. ) Margin: Sharp and sclerotic 4. ) Periosteal reaction: None, solid 5. ) Effect on adjoining structures: Chronic pressure deformity