Bone and Cartilage Pathology III

Question 1

chondrosarcoma

Answer 1

malignant tumor - producing cartilage

conventional, clear cell, dedifferentiated, or mesenchymal variants

Question 2

age of chondrosarcoma

Answer 2

> 40yo

Question 3

pelvis, shoulder, ribs

Answer 3

chondrosarcoma

see calcified matrix on Xray - as flocculent densities

Question 4

Xray scalloping

Answer 4

chondrosarcoma

Question 5

painful progressively enlarging mass

Answer 5

chondrosarcoma

higher grade - worse prognosis

tx - wide surgical excision

Question 6

ESFT

Answer 6

ewing sarcoma family tumors

-ewing sarcoma and PNET (primitive neuroectoderm tumors)

Question 7

8yo with diaphyseal tumor of long bones

Answer 7

ewing sarcoma family tumors

femur and flat bones of pelvis

also see fever, elevated sed rate, anemia, leukocytosis

Question 8

onion skin deposition of bone

Answer 8

ewing sarcoma family tumors

Question 9

homer wright rosettes

Answer 9

round groupings of cells with central fibrillary core

seen in ewing sarcoma family tumors
-more neuroectodermal differentiation

Question 10

rosettes

Answer 10

PNET

Question 11

tx of ESFT

Answer 11

aggressive malignancy

-neuadjuvant chemo with surgical excision

Question 12

multinucleated osteoclast giant cells

Answer 12

in giant cell tumor

-aka osteoclastoma

Question 13

prognosis of giant cell tumor

Answer 13

benign, but locally aggressive

in 20-40yo

Question 14

soap bubble

Answer 14

giant cell tumor in epiphysis

Question 15

location of giant cell tumor

Answer 15

epiphysis

Question 16

tx of giant cell tumor

Answer 16

curettage
-40-60% recur locally

4% mets to lungs

denosumab - RANKL inhibitor - adjuvant therapy

Question 17

ABC

Answer 17

aneurysmal bone cyst

Question 18

multiloculated blood filled cystic spaces separated by thin tan white septa

Answer 18

ABC

Question 19

location of ABC

Answer 19

metaphysis

Question 20

fluid fluid level

Answer 20

seen in ABC - aneurysmal bone cyst

Question 21

fibrous cortical defect

Answer 21

common -30-50% children over 2yo

metaphysis of distal femur - proximal tibia

50% bilateral/multiple

Question 22

fibrous cortical defect that grows to 5 or 6cm

Answer 22

nonossifying fibroma - not detected until adolescence or adulthood

Question 23

fibroblasts in pinwheel pattern

Answer 23

fibrous cortical defect and nonossifying fibroma

Question 24

asymptomatic and detected incidentally on Xray

Answer 24

fibrous cortical defects

Question 25

involve single bone

Answer 25

monostotic

fibrous dysplasia

often asymptomatic

Question 26

involve multi bones

Answer 26

polyostotic

fibrous dysplasia

more severe - crippling deformity and fractures

rare complication - sarcoma

Question 27

fibrous dsyplasia and soft tissue myxomas

Answer 27

mazabraud syndrome

Question 28

polyostotic disease, cafe au lait spots, precocious puberty

Answer 28

mccune albright syndrome

Question 29

fibrous dysplasia

Answer 29

B9 tumor
-localized developmental arrest

components of bone present - but don’t differentiate

Question 30

ground glass

Answer 30

fibrous dysplasia

Question 31

chinese characters

Answer 31

fibrous dysplasia

Question 32

intraspinal seeding

Answer 32

batsons plexus

Question 33

skeletal mets

Answer 33

often multifocal

Question 34

lytic

Answer 34

bone destroying

Question 35

blastic

Answer 35

bone forming

Question 36

prostatic adenocarcinoma

Answer 36

blastic

Question 37

kidney, lung, GI, melanoma

Answer 37

mets to skeletal system - lytic

Question 38

mets to bone

Answer 38

PBKTL

prostate
breast
kidney
thyroid
lung

Question 39

mutation of EXT

Answer 39

osteochondroma

Question 40

t(11:22)

Answer 40

ewing sarcoma family of tumors - aggressive and malignant