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MSS Weeks 3-5 > Bone, cartilage, and soft tissue tumors: Clinical Correlations > Flashcards

Bone, cartilage, and soft tissue tumors: Clinical Correlations Flashcards

1
Q

Common Bone Lesions

A
  1. Metastatic carcinoma
  2. Multiple myeloma
  3. Lymphoma of bone
  4. Osteosarcoma
  5. Ewing sarcoma
  6. **Unicameral bone cyst (UBC)**
  7. Aneurysmal bone cyst (ABC)*
  8. Enchondroma
  9. Osteochondroma
  10. Chondrosarcoma
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2
Q

Soft Tissue Lesions

A
  1. Lipoma
  2. Desmoid
  3. Soft tissue sarcoma
  4. Lymphoma
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3
Q

72 y/o F presents with L knee pain: Based on the image, what is the differential?

A
  1. Multiple Myeloma
  2. Lymphoma
  3. Bone Sarcoma
  4. Metastatic Disease
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4
Q

What is the most likely diagnosis?

A

Multiple Myeloma

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5
Q

When staging a bone lesion, what should you consider?

A
  • 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 adenocarcinoma)
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6
Q

What is the most likely disease?

A

Multiple Myeloma

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7
Q

Multiple Myeloma:

Characteristics

A
  • 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
  • Result in “pathologic fractures”
  • Cells produce a monoclonal immuno- globulin, most often IgG
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8
Q

What is the most likely diagnosis?

A

B cell lymphoma

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9
Q

What is the marker that would indicate this is B cell lymphoma?

A

CD20

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10
Q

What does this image suggest?

A

Osteosarcoma

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11
Q

Osteosarcoma histology

A

Osteosarcoma histology

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12
Q

Metastatic poorly differentiated adenocarcinoma, consistent origin in a primary lung adenocarinoma:

What are the markers?

A
  • Lung adenocarcinomas: one of four major types of lung carcinoma
    • Most common type of lung cancer in woman and nonsmokers
    • Metastases early (to bone, brain, and liver)

Clinical Markers

  1. TTF1: positive in adenocarcinomas arising in the lungs
  2. Cytokeratin: positive in carcinomas
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13
Q

Childhood lesions of bone:

A
  1. Osteochondroma
  2. Enchondroma
  3. Unicameral bone cyst
  4. Aneurysmal bone cyst
  5. Ewing sarcoma
  6. Osteosarcoma
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14
Q

10 y/o male presents with bone pain: What is the differential diagnosis?

A
  1. UBC- Unicameral Bone Cyst
  2. ABC- Aneurysmal Bone Cyst
  3. Giant Cell Tumor of Bone
  4. Osteosarcoma
  5. Ewing Sarcoma
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15
Q

What is the most likely diagnosis?

A

Unicameral Bone Cyst (UBC)

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16
Q

Unicameral Bone Cyst:

Characteristics

A

AKA: Solitary cyst or Simple Bone Cyst

  • Benign
  • Children & young adults
  • Metaphyseal region of long bones
  • Usually proximal femur or humerus
  • 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
17
Q

What is the most likely diagnosis?

A

Aneurysmal Bone Cyst (ABC)

NOTE THE FLUID-FLUID LEVELS

18
Q

Aneurysmal Bone Cyst (ABC):

Characteristics

A
  • Eccentric solitary expansile lesion
  • Mostly < 20 years
  • Swelling, pain, or tenderness
  • Metaphyseal region of long bones: common
    • But any bone may be involved
  • Cystic spaces filled with blood, but no endothelial cell lining
  • Between blood filled spaces are fibrous septa, giant cells & immature bone or osteoid
  • Recently discovered that it is a benign neoplasm with a characteristic translocation
19
Q

Aneurysmal Bone Cyst:

Treatment

A
  1. Curettage (it may recur)
  2. Embolization/sclerotherapy
20
Q

What is the most likely diagnosis?

(pure lytic lesion in the epiphysis)

A

Giant Cell Tumor of Bone

21
Q

What is the most likely diagnosis?

A

Osteosarcoma

mineralization in bone = osteosarcoma

22
Q

What is the most likely diagnosis

(10 y/o male with bone pain)

A

Ewing Sarcoma

23
Q
  • What is the marker for a Ewing sarcoma (+) stain?
  • What is the translocation in Ewing Sarcoma?
A
  • Marker: CD99
  • t(11,22) (90% of cases)
24
Q

56 y/o M with Painless thigh mass: What is the differential?

A
  1. Lipomas
  2. Soft tissue sarcomas
  3. Desmoid fibromatosis
  4. Lymphoma
25
Q

What is the most likely diagnosis?

26
Q

What is the most likely diagnosis?

A

Desmoid Fibromatosis

27
Q

What is this a positive stain of?

A

Beta Catenin (+) for Desmoid Fibromatosis

28
Q

Biopsy from a 56 y/o M with a painless thigh mass. What is the most likely diagnosis?

A

High-grade Undifferentiated Pleomorphic Sarcoma

29
Q

40 y/o F with pelvic pain and incidentally noted pelvic lesion: What is the differential?

A
  1. Enchondroma
  2. Osteochondroma
  3. Chondrosarcoma
30
Q
    1. Enchondroma
    1. Osteochondroma
    1. Chondrosarcoma

What do they have in common?

A

Tumors that deposit mineral

31
Q

What is the most likely diagnosis?

A

Enchondroma

32
Q

What is the most likely diagnosis?

A

Osteochondroma

33
Q

What is the most likely diagnosis?

A

Osteochondroma

34
Q

40 y/o F with pelvic pain and incidentally noted pelvic lesion. She also presents with this histological stain.

What is the most likely diagnosis?

A

Chondrosarcoma

MSS Weeks 3-5 (22 decks)

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