Bone lesions Flashcards
epiphyseal lucent lesion eccentrically located at the end of long bones
giant cell tumor
Multifocal giant cell tumors seen in what conditions?
Paget disease or hyperparathyroidism
Treatment for GCT
curettage or wide resection
LCH is caused by
abnormal proliferation of histiocytes
Classic appearance of LCH in the skull
beveled edge appearance
beveled edge appearance
LCH in the skull
floating tooth
LCH, 2/2 resorption of alveolar bone
Ewing sarcoma cell type
small round cell tumor
ewing sarcoma demonstrates male or female dominance?
male
Second most common pediatric primary bone tumor
ewing sarcoma
radiographic features of ewing sarcoma
aggressive lytic lesion in a child with permeative bone destruction, aggressive periosteal reaction, and soft tissue mass
most common primary bone tumor in patients over 40
multiple myeloma
what is sclerosing myelomatosis associated with?
POEMS syndrome: Polyneuropathy, organomegaly (liver/spleen), endocrine disturbances (amenorrhea/gynecomastia), monoclonal gammopathy, skin changes
Ivory vertebral body
lymphoma
most common soft tissue tumo
lipoma
circumscribed lucent lesion in the calcaneus with thin rim of peripheral sclerosis
intraosseous lipoma
most common sites for intra osseous lipoma
calcaneus, subtrochanteric region of the femur, distal tibia/fibula, and metatarsals
features suggesting well differentiated liposarcoma
large size (>10cm), thick septations, globular nodular soft tissue, or composition consisting of <75% fat
hollow fluid filled lesion typically found in the proximal diaphysis of the humerus or femur
simple bone cyst/unicameral bone cyst
location of simple bone cyst
central. typically at proximal diaphysis.
nonsurgical treatment option for simple bone cyst
intra-lesional injection of methylprednisolone –> induces osteogenesis
fallen fragment sign
simple bone cyst
What is typically more expansive, ABC or simple bone cyst?
ABC is more expansile. Typically SBC won’t be wider than the physis
Histologically what are ABCs made of?
blood filled sinusoids and solid fibrous elements
osseous mets are ____x more common than primary bone tumors
10x more common
Lytic mets
lung, breast, thyroid, kidney, stomach, colon
Blast mets
breast, prostate, seminoma, TCC, mucinous tumors, carcinoid
what is myositis ossificans?
heterotopic bone formation in the skeletal muscle secondary to trauma
most common sites for myositis ossificans?
elbow, thigh (more prone to trauma)
Evolution of myositis ossificans (time line)
weeks 1-2: soft tissue mass weeks 3-4: formation of osteoid matrix (may cause periosteal rxn to adjacent bone) weeks 5-8: periphery of lesion matures into compact bone up to 6 months: ossification continues to mature >6 mo: typically decreases in size
benign lytic lesion seen in patients with hyperparathyroidism
brown tumor in HPT
subperiosteal abscess.
happens in peds, Periosteum is loose in pediatrics and bone infection decompresses in the subperiosteal space
Periosteal chondroma
The radiograph and MR images depict a periosteal chondroma (synonym: juxtacortical chondroma), which is a benign, cartilage tumor arising on the surface of the bone deep to the periosteum. They have a predilection for the metaphysis of long bones. Radiographically, the lesion causes saucerization of the cortex with sclerotic margination and dense periosteal reaction along the proximal and distal ends of the lesion. Lesion matrix mineralization is present in approximately 75% of cases. The lesions are hypointense on T1-weighted and hyperintense on T2-weighted MR images, owing to the chondroid composition. The lesions are rare, accounting for <2% of all chondromas.
Ollier disease is associated with what malignant transformation
Chondrosarcoma
definition of a giant enostosis
> 2cm
osteopoikilosis inheritance pattern
AD
Do osteomas originate from the medullary cavity or cortex?
osteomas arise from the cortex
associated with Gardner syndrome
distribution of melorheostosis
usually lower limb in the distribution of a single sclerotome
treatment of osteoid osteoma
RFA, surgical curettage or resection
where do sarcomas metastasize?
the lungs
does Ollier or Maffucci syndrome have a higher risk of malignant transformation to chondrosarcoma?
Maffucci syndrome
cartilage cap thickness > ________ on MRI suggests malignant transformation of an osteochondroma
>1.5cm
unique signal characteristic of chondroblastoma on MRI
T2 dark
most common adult soft tissue sarcoma
MFH
