Bone Path III

Question 1

What are the 5 questions to ask with Bone neoplasia?

Answer 1

1) Pattern of Growth
2) Producing anything
3) Look like?
4) Cell/imaging => Ben/Mal
5) Dx agree w/ clinical picture and radiologic appearance?

Question 2

Where does Ewing Sarcoma usually occur?

Answer 2

Diaphysis (shaft)

Question 3

Where does Giant Cell Tumor usually occur?

Answer 3

Epiphisis (End of bone)

Question 4

Where does Chondrosarcoma usually occur?

Answer 4

Metaphysis (center)

Question 5

Where does Osteosarcoma usually occur?

Answer 5

Physis (off Center)

Question 6

What are the traits of an osteoma?

Answer 6

Benign tumor of mature bone
Asymptomatic
Local and mechanical problems
Cortical Bones of Skull and Face

Question 7

What are the Traits of osteoid osteoma and Osteoblastoma?

Answer 7

Benign. X-Ray Central Area of tumor radiolucent.

PAINFUL lesions relieved by aspirin (OO, not in OBA)

Question 8

What are the traits of Osteoblatoma?

Answer 8

Vertebral column
Radiolucent nidus
Histo Identical to OO
Pain not relieved by Aspirin

Question 9

What are the Traits of Osteosarcoma?

Answer 9

MALIGNANT 
Have to See OSTEOID
Most common 1^malignant tumor of bone
BIMODAL Age Distribution
Metaphysis of long bones

Question 10

What are the clinical traits of Osteosarcoma?

Answer 10

Bone PAIN, Swelling, Path Fracture

AGRESSIVE 20% w/ pulm mets at time of Dx

Question 11

What are the most common locations for Osteosarcoma?

Answer 11

Around Knee 60%
Prox Femur 15%
Prox Humerus 10%

Question 12

What is Codman’s Triangle?

Answer 12

Elevation of periosteum to produce an angle between surface of involed bone

Question 13

Lamellated

Answer 13

Multilayered “Onion Skin”

Question 14

Spiculated

Answer 14

“Sunburst” or “Hair on End”

Question 15

What are the traits of Osteochondroma?

Answer 15

Young men

Metaphysis, Epiphyseal Plate, Polypoid Growth on x ray. Tx: Excision

Question 16

What are the Traits of Chondroma?

Answer 16

Benign tumor of Hyaline Cartilage. Well circumscribed. Medullary cavity => Enchondromas

Question 17

What is Ollier Disease?

Answer 17

Multiple Enchondromas

Question 18

What is a chondrosarcoma?

Answer 18

Pelvic Bones, Axial Skeleton, Multilobular. Prog depends on Grade and size

Question 19

What factors tell you agressiveness of Chondrosarcoma?

Answer 19

Cellularity, Deg of nuclear atypia, Mitotic activity

Question 20

What are the traits of Ewing Sarcoma?

Answer 20

Small round blue tumors. Primitive Neural tumor
EWS => Undiff
PNET => Neural Diff

Question 21

What are found on Histology of Ewing Sarcoma?

Answer 21

Uniform “Small round blue” cells w/ round nuclei “nested” aggregates
PAS
CD99 +

Question 22

What are the traits of Fibrous Cortical Defect?

Answer 22

Common. Devt Defect. Metphysis. Multiple commonly in the knee. Small. Asymptomatic. incidental X-ray finding.

Question 23

What are the traits of Fibrous Dysplaia?

Answer 23

Woven Bone. Good Prognosis. Radiolucent, in diaphysis

Question 24

What are the traits of Giant cell tumors of Bone?

Answer 24

Osteoclastoma. Unommon. EPIPHYSIS of long bones around the knee. Mature skeleton.

Question 25

What are the traits of Metastatic tumors to bone?

Answer 25

Most OSTEOLYTIC
some osteoblastic (prostate)
Usually multiple