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Clinical Med and Diagnostic > Bone Tumors 1 /2- Mahoney > Flashcards

Bone Tumors 1 /2- Mahoney Flashcards

1
Q

What is still the single best radiologic test to help diagnose bone lesions, including tumors

A

The plain radiograph

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2
Q

Soft tissue mass adjacent to a bone tumor is considered ____

A

malignant (until proven otherwise)

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3
Q

Margins

Narrow: Values

A
  1. 1-1.0 mm

- tumor and surrounding normal bone are touching, and you see it surrounded by either a sclerotic or lytic margin

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4
Q

Margins

Wide: Values

A

2-10 mm

  • but in between the two there is an area that is indistinct that looks like it might be partially damaged
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5
Q

Margins

_____ - margin may be several centimeters or it may be impossible to measure the margin

A

Poorly defined:

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6
Q

-lesions with a distinct margin, whether or not it is sclerotic

A

geographic lesions

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7
Q

growth is more rapid, there may not be enough time to retreat orderly, and the margin becomes ill-defined

A

moth-eaten” appearance-usually suggests malignancy

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8
Q

Ill-defined pattern of lucency caused by many, small, irregular holes in the bone

A

permeative” pattern, usually associated with aggressive infection or malignancy

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9
Q

Moth eating and permeative are all ______

A

Malignant

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10
Q

If the lesion grows in fits and starts, periosteum may have time to lay down thin shell of calcified new bone before the lesion starts another growth spurt-leads to concentric shells of new bone over the lesion

A

lamellated or “onion-skin”

  • associated with Ewings sarcoma
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11
Q

Rapid growth of bone –> appearance-periosteum has no time to lay down bone, but Sharpey’s fibers become stretched out perpendicular to the bone, and then ossify-lesion is malignant until proven otherwise

A

“sun-burst” or “hair-on-end”

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12
Q

only the edges of the raised periosteum will ossify-this little bit of ossification forms a small angle with the surface of the bone, but not a complete triangle

A

Codman’s “triangle

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13
Q

Often caused by the tumor breaking out of cortex into the soft tissue

A

Codman’s “triangle

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14
Q

The x-ray sign that is least likely to occur with an aggressive bone tumor is:

Codman’s triangle
Sunburst appearance
Lamellated periosteum
Geographic bone matrix
Permeative bone matrix
A

Geographic

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15
Q

Diffuse Periosteal Reaction

Venous stasis

A

Can cause a psedu osteomyelitis

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16
Q

The substance in bone produced by osteoblasts and chondroblasts

A

Matrix

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17
Q

______matrix tends to be dense and confluent (“cloudy”)

A

Osseous

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18
Q

_______ matrix tends to produce small punctate or swirled area of calcification

A

Chondroid

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19
Q

This bone tumor has a ground glass appearance on x-ray:

A

Non-ossifying fibroma

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20
Q
  1. osteochondroma
    1. solitary enchondroma
    2. chondroblastoma
    3. chondrosarcoma
A

Cartilage-forming tumors (“chondro”)

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21
Q
  1. Osteoid osteoma and osteoblastoma

2. Osteogenic sarcoma

A

Bone-forming tumors (“osteo”)

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22
Q
  1. Osteogenic sarcoma
    1. Chondrosarcoma
    2. Fibrosarcoma
    3. Ewing’s sarcoma
    4. Metastatic carcinoma
A

Malignant tumors

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23
Q

Vast majority of bone tumors are going to be in the _____ type

A

Lytic

24
Q

FOGMACHINES stands for?

A 
F	fibrous dysplasia
O	osteoid osteoma/osteoblastoma
G	giant cell tumor
M	metastasis, myeloma
A	aneurysmal bone cyst
C	chondroblastoma, chondromyxoid fibroma
H	hyperparathyroidism, hemangioma
I 	infection
N	non-ossifying fibroma
E	eosinophilic granuloma, enchondroma
S	solitary bone cyst, sarcoidosis

Solitary lytic lesions of bone

25
Q

(“long lytic lesion in a long bone”)

A

Fibrous Dysplasia

Non-ossifying Fibroma –> looks alike

26
Q

Small <2cm
Occurs in younger

  • dervided from bone tissue surrounded by sclerotic tissue

lesion (“hurts like a ‘b’ and tough to see”)

What can help with the pain?

A

Osteoid osteoma

Night pain relieved by ASA

27
Q

At the end of a long fast, teens have a blast”

Benign lesion of bone composed of osteoid tissue intermixed with woven bone in a vascular connective tissue stroma

most common tumor in teens at the ends of long bones)

A

Osteblastoma

28
Q

Aggressive tumor composed of well vascularized stroma with oval tumor cells and multinucleated tumor giant cells

A

Giant Cell Tumor

  • May metastasize to lungs or transform to fibrosarcoma or osteogenic sarcoma
29
Q

Most probable cause of osteolytic metastases in a child is _______

A

neuroblastoma

In an adult male, CA of lung
In an adult female, CA of breast
CA of kidney and thyroid

30
Q

_________ is most common primary malignant tumor of bone in the body

A

Myeloma

31
Q

Arteriovenous or other vascular anomaly resulting from a local circulatory disturbance in bone
Diagnostic: On MRI-”Mosaic glass on MRI”

A

Aneurysmal Bone Cyst

Expands bone on CT but doesnt break perosteum

32
Q

(“chicken-wire matrix”)

A

Chondroblastoma

Chondromyxoid fibroma –> has no chicken wire

33
Q

“Brown tumors”-hemosiderin deposition in bone matrix that is being rapidly turned-over w/o adequate calcification

Subperiosteal bone resorption is hallmark, especially in phalanges

A

Hyperparathyroidism

  • dont lose osteoblastic activity just much slower
34
Q

“Long striations with long lucencies

A

Hemangioma

35
Q

fibrous cortical defect (FCD) in metaphyseal area of bone caused by periosteal fibroblastic proliferation

A

Non-ossifying Fibroma

36
Q

Bubbly lesions of bone***

NFC GAMES

A 
Nonossifying fibroma
Fibrous dysplasia
Chondrosarcoma
Giant cell tumor
Aneurysmal bone cyst
Metastatic CA
Enchondroma/Ewing’s sarcoma
Solitary bone cyst
37
Q

End of bone with speckled tone”)

Composed of mature hyaline cartilage in the medullary cavity

A

Enchondroma

38
Q

Granulomas in a bone that are filled with eosinophils

A

Eosinophilic Granuloma

39
Q

(“endosteal scalloping”)

A

Eosinophilic Granuloma

40
Q

Almost exclusively in the calcaneus, under the middle facet (“Best bet is middle facet”)

Commonly associated with a “fallen fragment” sign

A

Solitary bone cyst (Unicameral bone cyst)

41
Q

Of FOGMACHINES these are the ones that produce more than one.

Multiple Lucent Bone Lesions

A 
H  	hyperparathyroidism/hemangioma
I  	infection
F	fibrous dysplasia
E	enchondroma/eosinophilic granuloma
M	metastasis/myeloma
42
Q

Lytic Lesions in Metaphysis

“Cage On Mud”

A

C chondroblastoma
A aneurysmal bone cyst
G giant cell tumor
E enchondroma, Ewing’s sarcoma

O osteoblastoma, osteosarcoma, osteomyelitis
N non-ossifying fibroma

M malignant fibrous histiocytoma (fibrosarcoma)
U unicameral bone cyst
D desmoid tumor

43
Q

Best classified by age:

<1
A

neuroblastoma

44
Q

Best classified by age:

1-10
A

Ewing’s sarcoma

45
Q

Best classified by age:

10-30
A

osteosarcoma, Ewing’s

46
Q

Best classified by age:

30-40

A

fibrosarcoma, lymphoma

47
Q

Best classified by age:

40+
A

metastasis, myeloma,

chondrosarcoma

48
Q

“moth-eaten”
“onion-skin”
soft tissue mass

A

Ewing’s Sarcoma

forefoot –>survival high

49
Q

_________ develops in places of active growth

A

Osteogenic Sarcoma (Osteosarcoma)

50
Q

Most common malignant BONE tumor in foot and ankle

A

Chondrosarcoma

51
Q

When bone lesion is white or scelerotic what pneumonic should be used?

A

C chronic osteomyelitis
O osteochondroma
P Paget’s disease

B breast metastasis
O osteogenic sarcoma
B bone island*** Most commonly seen
S stress fracture

H hemangioma
I infarct *** Will look sclerotic not lytic
P prostate metastasis

52
Q

ceases growth at the time of skeletal maturation

Has a cap of hyaline cartilage and projects away from the epiphysis from which it arises

A

Osteochondroma

53
Q

“Flame-shaped” or “blades of grass” radiolucent lesions of bone which accentuates the areas of sclerosis

A

Paget’s Disease

54
Q

Non-neoplastic tumor-like lesion of bone (heterotopic ossification)

skeletal muscle of extremities following trauma

A

Myositis Ossificans

55
Q

This bone lesion is generally sclerotic in appearance, arises from an epiphysis, and grows towards the opposite end of the bone.

Subungual exostosis
Bone island
Giant cell tumor
Bone infarct
osteochondroma
A

osteochondroma

56
Q

The most likely primary bone malignancy in an adult > 40 is:

A 
Ewing’s sarcoma
Chondrosarcoma
Osteogenic sarcoma
Metastasis from kidney
fibrosarcoma

Clinical Med and Diagnostic (10 decks)

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