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Pathology > Bone Tumors > Flashcards

Bone Tumors Flashcards

1
Q

Primary or secondary bone tumor is more common?

A

Primary bone tumors are less common than bone metastases

secondary bone tumors

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2
Q

most common primary bone cancer, ?

A

Osteosarcoma

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3
Q

Osteosarcoma is the most common primary bone cancer, • Then ? And?

A

chondrosarcoma and Ewing sarcoma.

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4
Q

Benign or malignant tumor more common?

A

Benign tumors the commonest, with greatest frequency within the
first three decades of.

  • Bone tumors in elderly persons are much more likely to be
    malignant.
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5
Q

Etiology of bone tumor ?

A

Idiopathic •Genetic syndromes •Bone infarcts, •Chronic osteomyelitis, •Paget disease, • Irradiation. •Fibrous dysplasia • Use of metal orthopedic devices.

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6
Q

Clinical presentation of bone tumors ?

A

•Benign lesions : asymptomatic detected as incidental findings. •Others produce pain or a slowly growing mass
. •Pathologic fracture

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7
Q

Investigations of bone tumor ?

A

•Radiologic imaging •Biopsy

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8
Q

Bone forming primary bone tumors

Benign ? Malignant ?

A
  • Osteoma
    Osteoid osteoma
  • Osteosarcoma
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9
Q

Cartilage Forming
Primary Bone Tumors
B / m

A

Enchondroma/Chondrosarcoma

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10
Q

Fibroblastic Tumors
Primary Bone Tumors

Benign Malignant

A

Fibroma Fibrosarcoma

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11
Q

Undetermined Origin
V Primary Bone Tumors
Locally Malignant

A

Giant Cell Tumor (Osteoclastoma)

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12
Q

Secondary Secondary

A

Metastatic Tumors (The Commonest)

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13
Q

Osteoma

Type of lesion ? Most common site? Age?

A

• Benign lesions • Head and neck, including the paranasal

sinuses, • Can occur elsewhere • Middle age

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14
Q

• Mixture of woven and lamellar bone.

A

Osteoma

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15
Q

Cause local mechanical problems (e.g.,

obstruction of a sinus cavity)

A

Osteoma

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16
Q

Do not undergo malignant transformation

?

A

Osteoma

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17
Q

Osteoid Osteoma and Osteoblastoma

Type of lesion ? Age? Gender ?

A

•Benign neoplasms •The teenage years and 20s, with a male predilection

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18
Q

Osteoid Osteoma and Osteoblastoma

Distinguished from each other, primarily by ?

A

their size, site and clinical presentation.

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19
Q

Arise beneath the periosteum in the proximal femur and tibia or posterior spinal elements ?

A

Osteoid osteomas

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20
Q

Less than 2 cm in diameter ?

A

Osteoid osteomas

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21
Q

Localized pain, most severe at night, relieved by aspirin.

?

A

Osteoid osteomas

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22
Q

Larger than 2 cm ?

A

Osteoblastomas

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23
Q

Involves the spine more frequently ?

A

Osteoblastomas

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24
Q

Cause pain not responsive to aspirin.

?

A

Osteoblastomas

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25
Q

Osteoblastomas

Treatment?

A

Local excision is the treatment of choice.

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26
Q

Malignant transformation is rare

?

A

Osteoblastomas

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27
Q

Shows radiolucent well-defined area, surrounded by a halo of dense reactive bone

-X-ray ?

A

Osteoid osteomas:

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28
Q

Gross: lesions are round-to-oval masses of hemorrhagic gritty tan tissue
Type of tumor ?

A

Osteoid osteomas:

29
Q

Microscopically: Nidus, well circumscribed and composed of randomly interconnecting trabeculae of woven bone that are prominently rimmed by benign looking osteoblasts

Type of tumor ?

A

Osteoid osteoma

30
Q

The stroma surrounding the neoplastic bone consists of loose connective tissue that contains many dilated and congested capillaries. Reactive sclerotic bone surrounding the nidus

Type of tumor?

A

Osteoid osteoma

31
Q

composed of haphazardly interconnecting trabeculae of woven bone that are rimmed by prominent osteoblasts. The intertrabecular spaces are filled by vascularized loose connective tissue.

A

Osteoid osteoma

32
Q

a bone-producing malignant mesenchymal

tumor. ?

A

Osteosarcoma

33
Q

Most common primary malignant tumor of bone.

A

Osteosarcoma

34
Q

Osteosarcoma

Age? Gender/ site ?

A

75% of patients are younger than 20 years of age. • With a second peak occurring in elderly persons, • Men are more affected than women • Most tumors arise in the metaphyseal region of the long bones of
the extremities, • 60% occurring about the knee, 15% around the hip, 10% at the
shoulder, and 8% in the jaw.

35
Q

essential for diagnosis of ?

The production of mineralized or unmineralized bone (osteoid)

A

osteosarcoma

36
Q

PATHOGENESIS of Osteosarcoma?

A
  1. RB gene mutations occur in 60% to 70% of sporadic tumors. Hereditary retinoblastomas have a thousand-fold greater risk for development of osteosarcoma
  2. p53, a gene whose product regulates DNA repair
37
Q

Radiographic imaging: a large, destructive, mixed lytic and blastic mass
Tumor ?

A

Osteosarcoma

38
Q

The tumor frequently breaks through the cortex and lifts the periosteum, resulting in reactive periosteal bone formation.

?

A

osteosarcoma

39
Q

X A triangular shadow on the x-ray between the cortex and raised periosteum (Codman triangle) •Spread hematogenously; 10% to 20% pulmonary metastases,

Tumor ?

A

osteosarcoma

40
Q

Spread hematogenously; 10% to 20% pulmonary metastases,

Tumor?

A

osteosarcoma

41
Q

Secondary osteosarcomas occur in?

A

older adults most commonly in the setting of Paget disease or previous radiation exposure

42
Q

Vriable. Solid- cystic, soft-bony gritty, gray-white tumors, often exhibiting hemorrhage and cystic degeneration
Tumor?

A

osteosarcoma

43
Q

Malignant polygonal cells (osteoblasts), showing criteria of malignancy (vary in size and shape (pleomorphic), hyperchromatic nuclei; bizarre tumor giant cells and mitoses •Osteoid, eosinophilic, lace-like •The formation of bone by the tumor cells is characteristic

A

osteosarcoma

44
Q

Histologic appearance, with coarse, lacelike pattern of neoplastic bone (arrow) produced by anaplastic tumor cells. Note the wildly aberrant mitotic figures (arrowheads).

A

osteosarcoma

45
Q

Osteochondroma

Type ? Gender ?

A

Benign / More in males

46
Q

Composed of bony projections with cartilagenous cap that arises from the
surface of the bone. ?

A

Osteochondroma

47
Q

• Slow-growing masses . • Incidental findings. • Bone protrusion and pain (pressure on nerves).

Tumor ?

A

Osteochondroma

48
Q

rarely progress to to benign although they may recur if if

A

Solitary osteochondromas

49
Q

Malignant transformation occurs more frequently in?

A

in multiple hereditary

osteochondromas.

50
Q

• X-ray: cartilage capped bony growth. The
medullary cavity and cortex are
continuous with that of bone, growth is
away from joint

A

Osteochondroma

51
Q

Grossly: cartilage cap overlying bone ?

A

Osteochondroma

52
Q

Microscopically:
cartilage cap, composed of hyaline
cartilage with active endochondral
ossification (similar to that of epiphyseal
plate). Bony stalk is formed of cortical
lamellar bone.

A

Osteochondroma

53
Q

Chondrosarcoma

Age? Site /

A

Old age, 4th-5th decade • At medullary cavity of pelvic bone, shoulder, and ribs;

54
Q

Painful, progressively enlarging masses • Destroys the cortex and forms a soft tissue mass.
?

A

Chondrosarcoma

55
Q

X ray:
Ill-defined, thickened shaft, stippled appearance or ossification of
cartilage, cortex infiltrated by tumor.

A

Chondrosarcoma

56
Q

Gross: Cartilagenous growth, hemorrhage and necrosis

A

Chondrosarcoma

57
Q

Microscopic: Cartilage cells with variable degree of atypia, calcification,
myxoid cartilaginous matrix.

A

Chondrosarcoma

58
Q

Contain osteoclast-type giant cells

(Osteoclastoma) ?

A

Giant Cell Tumor

59
Q

Giant Cell Tumor

Type of lesion? Age?

A

It is benign but locally aggressive • 20-40 years of age

60
Q

Giant Cell Tumor

Site?

A 
Epiphysis and metaphysis of long bone
around knee (distal femur and proximal
tibia) • Pain esp. joint pain and pathologic fracture
61
Q

Gross • large, Red-brown tumor with cystic degeneration

A

Giant Cell Tumor

62
Q

Microscopic • Composed of uniform oval mononuclear cells that constitute the
proliferating component of the tumor. • Scattered within this background are numerous osteoclast-type
giant cells having 100 or more nuclei.

A

Giant Cell Tumor

63
Q

Necrosis, hemorrhage, hemosiderin deposition, and reactive bone
formation are common secondary features.

A

Giant Cell Tumor

64
Q

Primary malignant small round cell tumors of bone and soft tissue ?

A

Ewing Sarcoma

65
Q

After osteosarcoma, it is the second most common pediatric bone
sarcoma. ?

A

Ewing Sarcoma

66
Q

Ewing Sarcoma

Age ? Site ?

A

80% are younger than 20 years. • Painful enlarging mass in the diaphysis of long tubular bones
(especially the femur) and the pelvic flat bones. • chemotherapy and surgical excision

67
Q

The commonest bone tumor ?

A

Metastatic Disease

68
Q

Mostly affecting the axial skeleton (red marrow, rich

vascularity) ?

A

Metastatic Disease

69
Q

Radiographic: purely lytic lesion (kidney and lung tumors),

osteoblastic (prostatic adenocarcinoma), or mixed

A

Metastatic Disease

Pathology (4 decks)

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