9. Pathology of Bone & Joints-3

Question 1

A 49 year old woman comes to here doctor with symptoms of untended weightless over 5 months, fatigue and pain. A bone biopsy is done a the sample is believe to have been from a metastatic. Which site of the listed is most likely primary site.

A. Kidney
B. Pancreas 
C. Liver 
D. Brain
E. Uterus 

RFA

Answer 1

Ans. A. Kidney- the most common site for metastatic bone cancer are BLT and Kosher Pickles ( Breast, Lung, Thyroid, Kidney and Prostate)

Question 2

A pathologist is given a sample of bone to screen for metastatic growth. The doctor who gave it to him told him the sample is from the femur but nothing else. After examining the specimen he finds it notable for soap bubble appearance. What else is most likely true given this information?

A. The sample is from the Diaphysis
B. The pain caused by the tumor responds to Aspirin
C. The sample is from the Metaphysis
D. The tumor originates from neuroectoderm cells
E. The sample is from the Epiphysis

RFA

Answer 2

Ans. D. The sample is from the Epiphysis- The patient has a Giant Cell Tumor( soap bubble appearance and usually in the femur) it is the only tumor in the Epiphysis.

A. Diaphysis- tumors are Ewing Sarcoma, Osteoid osteoma

B. Pain relieve by Aspirin- is Osteoid Oseoma( present as dark spot)

C. Metaphysis- Osteosarcoma( related to Paget’s disease), Osteochondroma( lateral projection from the growth plate)

D. Tumor originates from neuroectoderm- Ewing Sacoma( bones of leg, Onion skinning, sheet of small round cells, due to Ch11/12 tran relocation)