bone tumors Flashcards
permeated lesions
motheaten; confluent little holes
fast growing things
sclerotic/geographic margin
slow growing lesion so that bone has time to respond to it
–bone thickened around sharp margin
lesion mineralization suggests
it contains calcium
with calcium, a dense lesion in the bone shaft may be
hard to catch
stipped, flocculent and rings and arches patterns suggest
cartilage is mineralizing
periosteium reflects
triggers inside and outside the bone that determine speed of growth
slow growing cortical lesion
continuous pattern of periosteum around it- forming bump
onion skin pattern in periosteum reflects
waxing and waning of growth speed
interrupted pattern reflects
fast growth
flocculent
calcified cartilage where it shouldnt be
slow growth rate
georgraphic margin
solid periosteal rxn
intermediate growth rate
ill defined internal margin/moth eaten
shells periosteal rxn
fast growth rate
permeative internal margin
lamellar periosteal rxn
Fastest growth rate
invisible internal margin
periosteal rxn spiculated invisible
geographic lesions include
cysts chondroma fibrous dysplasia giant cell tumor chrondrosarcoma osteomyelitis metastasis
moth eaten tumors include
osteosarcoma ewing sarcoma chondrosarcoma osteomyelitis metastasis
permeative tumors include
osteosarcoma ewing sarcoma chondrosarcoma osteomyelitis metastatsis
tumors of the diaphysis
ewing sarcoma (middle) osteoid osteoma (edge) fibrous dysplasia (middle small) chondromyloid fibroma( edge with metaphysis)
tumors of metaphysis
cysts (middle) osteochondroma (sticking off side) osteosa (large middle) non-ossifying fibroma (side) cartilage neoplasms (middle) giant cell tumor (edge + epiphysis)
epiphysis tumors
chrondroblastoma
what tumor is not seem in kids
chondrosarcoma
what tumor is not seen in metaphysis
ewing
what suggests osteomyelitis
increase WBC with a swollen finger
primary bone lesions are usually
signular
bone forming tuors (2)
osteoid osteoma
osteosarcoma
cartilage forming tumors (3)
osteochrondroma
chonrome
chrondosarcoma
round cell maliginancies
ewing’s tumor
lymphoma
multiple myeloma
fibrous tumor like conditiosn
fibrous dysplasia
fibrous dysplasia
diaphyseal, intramedullary fusiform lesiosn with a ground glass appearance that can be associated with growth deformities
histo of fibrous tumor-like conditions
spindle cells in a colalgenous matrix with woven bone
clinical releavance of fibrous dysplasia
greater in female
usually in children
ewing’s sarcoma
childhood malig of primitive mononuclear cells, often presents a diagnostic challenge since its pathological presnetation can mimic ALL and metastatic neuroblastoma
where in bone is ewing’s
meta-diaphyseal permative lesion with prominent periosteal rx
clinical path of swing’s
age range 5-15 years
presentation with pain
mets to other bones and lung
molecular cytogenetics of ewings
translocation of chrom 11;22 –>results in fusion protein EWS FLI-1
osteosarcoma path
metaphyseal, most often about the knee (most active bone growth)
radio appearance depends on histo (osteoblastic vs chondroblastic) and location (intramedullary, cortical, periosteal)
clinical age for osteosarcoam
10-25 years, more in men
clinical presentation osteosarcoma
pain–persistant and sometimes welling or pathologic freacture
mets blood and pulm
giant cell tumor is
benign but aggressive
giant cell tumor path
metaphyseal lytic lesion ususally appearing after closure of the growth plates and therefore can extend epiphyseally; usually above the knee
clinical course of giant cell tumor
ages 20-40 years
may present with pain, pathologic fracture, and recurrence rate is high if primary surgical treatment is inadequate
chrondosarcoma is
malginant
chrondosarcoma can be both
intramedullary or peripheral
clinical path of chrondrosarcoma
adults, usually >50
slwolwy enlarging
sometimes painful–can become quite large, particularly when they arise in pelvic bones
osteomyelitis
sweollen and painful arm
staph osteomylitis shows
empty trabeculae (dead osteoblasts)
tx of osteomyelitis
w/ IV abx
benign endochondroma
varaibale radiographic appearance depdenent on size, location of bone, degree of calc
lytic with speckled calcification- usually solitary although multiple forms are seen and represent rare clinical syndromes
Ollier’s
> 1 chrondroma with fibrous displasia (in ref to endochondromas)
Maffuci’s
> 1 chondroma with angiomata (in ref to endochondroma)
clinical present wtih benign endochondroma
variable presentations –most common being that of an incidental radiographic finding
osteoid osteoma is
benign
osteoid osteoma path
diaphyseal
usually cortical in location with sclertoci thickening within which a small lucent nidus is found
nidus is composed of
rich vascularized disorganized woven bone and osteoid
clinical presenation of osteoid osteoma
adolescents (3:1 male:F)
50% femur
pain, progressive severity, often at night
how is osteoid osteoma relieved
with aspirin
