Bone Tumors Flashcards
Prominent osteoblasts w/ rim of reactive cortical bone
Osteoid osteoma + osteoblastoma
Symptoms of chondrosarcoma
Painful, progressively enlarging mass
Location of involvement of osteochondromas
Metaphysis of long tubular bones esp. near knee
Location of giant cell tumor involvement
Epiphysis of long bones
Osteolytic bone metastasis
Breast, kidney, lung mets
Associated w/ Gardner syndrome
Osteoma
Gardner syndrome= FAP + osteoma + fibromatosis of retroperitoneum
Benign bone forming tumors (3)
1) Osteoma
2) Osteoid osteoma
3) Osteoblastoma
Malignant proliferation of poorly differentiated cells derived from neuroectoderm
Ewing sarcoma
Difference between osteochondroma + hereditary multiple exostosis
Multiple herediatry exostosis has significantly increased risk for chondrosarcoma
Imaging findings for osteoid osteoma + osteoblastoma
Radiodense bony mass w/ lucent core (osteoid) within cortex
Risk factors/ epidemiology of primary osteosarcoma
Risk factors: Li-Fraumeni syndrome, Familial retinoblastoma, radiation
Epidemiology: Teenagers
Osteoblastic metastasis
From prostate CA
Histology: Disorganized cartilage in growth plate
Osteochondroma
Risk factors/ epidemiology of secondary osteosarcoma
1) Radiation
2) Paget disease
3) Bone infarcts
Malignant proliferation of osteoblasts
Osteosarcoma
Benign cartilage forming tumors (2)
1) Osteochondroma (& multiple hereditary exostosis- increased risk for chondrosarcoma)
2) Echondroma (& multiple echondroma disorders- increased risk for chondrosarcoma)
Histology of Ewing sarcoma
Small, round blue cells resembling lymphocytes (can be misdiagnosed as lymphoma)
Homer Wright rosettes
Location of involvement of echondroma
Medullary cavity of small bones (hands + feet)
Location of involvement of secondary osteosarcoma
Femur, pelvis, humerus
Etiology of Ewing sarcoma
t(11;22) –> fusion protein EWS-FLI1
Location of involvement of Ewing sarcoma
Diaphysis of long bones
Tumor of osteoblasts that make large amounts of RANKL, stimulating osteoclasts to grow
Giant cell tumor
Location of involvement of osteoid osteoma
Diaphysis of long bones (e.g. femur) within cortex
Two diseases that appear same on imaging
Echondroma + chondrosarcoma- both appear lucent w/ internal mineralization
Location of chondrosarcoma involvement
Medulla of pelvis or axial skeleton (shoulder, pelvis, proximal femur, ribs)
Multiple echondroma disorders (2)
Ollier disease, Maffuci syndrome; associated w/ multiple sites of echondromas; increased risk of chondrosarcoma
Histology of osteosarcoma (primary and secondary)
Malignant osteoblasts forming osteoid (disorganized pink matrix)
Bone pain that resolves w/ ASA
Osteoid osteoma
Location of involvement of primary osteosarcoma
Metaphysis of long bones, usually around the knee (distal femur, proximal tibia)
Histology of giant cell tumors
multinucleated giant cells that express RANKL
Symptoms of Ewing sarcoma
Painful, enlarging mass that’s frequently tender, warm, swollen
Systemic findings: fever, anemia, leukocytosis
Histology of osteoid osteoma
Woven bone w/ prominent osteoblasts + rim of reactive cortical bone
Differences between osteoid osteoma + osteoblastoma (3)
1) Location of involvement: osteoid osteoma involves diaphysis of long bones while osteoblastoma involves vertebrae.
2) Size- osteoid osteoma is less than 2 cm; osteoblastoma is larger than 2 cm
3) Aspirin- osteoid osteoma bone pain resolves with ASA; osteoblastoma bone pain doesn’t resolve w/ ASA
Common location of osteomas
Facial bones/ skull
Symptoms of osteosarcoma
Bone pain, pathologic fractures. No systemic sx.
“Sunburst” appearance + Codman’s triange (lifting of periosteum) on imaging
Osteosarcoma (primary and secondary)
Malignant cartilage forming tumor
Chondrosarcoma
Cartilage-capped tumor attached by bony stalk (exostosis) to underlying skeleton
Osteochondroma
Benign tumor of hyaline cartilage
Echondroma
Soap bubble appearance on x-ray
Giant cell tumor
Location of giant cell tumor involvement
Epiphysis of long bones, usually region of knee (distal femur/ proximal tibia)
Histology of echondroma
Nodular hyaline cartilage w/ overlying rim of reactive bone