Bone Tumors Flashcards
Two most important determinant in the analysis of a potential bone tumor are:
- morphology of the bone lesion on a plain radiograph
2. age
Most useful examination for differentiating bone lesions
conventional radiography
Most reliable indicator in determining
whether these lesions are benign or malignant
zone of transition between the lesion and the adjacent normal bone
This is common (in differential dagnosis) to all age group and morphology.
Infection
Determining the type of lesion by its zone of transition applies to osteolytic or sclerotic lesions?
Osteolytic
*sclerotic lesions have a narrow transition zone
What type of transition is being described:
transition results in a sharp, well-defined border and is a sign of slow growth.
Small zone of transition
Most common bone tumors In patients > 40 years.
Metastases and multiple
myeloma
Type of transition being described:
- ill-defined border with a broad zone of transition is a sign of aggressive growth
- a feature of malignant bone tumors.
Wide zone of transition
What are the two tumor-like lesions which may
mimic a malignancy and have to be included in
the differential diagnosis.
infections, eosinophilic granuloma
*these two are may have an aggressive growth pattern but are actually benign.
Describe appearance of infections and eosinophilc granuloma.
Ill-defined margins, but
cortical destruction and an aggressive type of
periosteal reaction may also be seen; benign.
Non-specific reaction
and will occur whenever the periosteum is irritated by a malignant tumor, benign tumor, infection or trauma.
Periostal reaction
Two patterns of preiosteal reaction.
Benign and an aggressive type
Benign type is seen in benign lesions such
as benign tumors and following trauma.
T/F
True
An aggressive type is seen in malignant tumors, but also in benign lesions with aggressive behavior, such as infections and eosinophilic
granuloma.
T/F
True
Malignant lesion will cause benign periosteal reaction.
T/F
False
Benign/aggresive type
- thick, wavy and uniform callus formation resulting from chronic irritation.
Benign periosteal type
- multilayered, lamellated or demonstrates bone formation perpendicular to the cortical bone
- Codman’s triangle
aggressive periosteal type
Elevation of
the periosteum away from the cortex, forming an angle where the elevated periosteum and
bone come together.
Codman’s triangle
A special type of cortical destruction of endosteal cortical bone and the addition of new bone on the
outside occur at the same rate, resulting in expansion.
Ballooning
A benign, well-defined, expansile lesion with regular destruction of cortical bone and a peripheral layer of new bone.
Chondromyxoid fibroma
A locally aggressive lesion with cortical
destruction, expansion and a thin,
interrupted peripheral layer of new bone.
Giant cell tumor
Two types of mineralization
- a chondroid matrix in cartilaginous tumors
2. chondrosarcoma and an osteoid matrix in osseus tumors
Matrix described as: rings-and-arcs, popcorn, focal
stippled or flocculent.
Chondroid matrix
Matrix described as: trabecular ossification pattern in benign bone-forming lesions and as a cloud-like or ill-defined amorphous pattern in osteosarcomas.
Osteoid matrix
Multiple osteolytc lesions: FEEMHI
Fibrous dysplasia, enchondromas, EG, Mets and myeloma, Hyperparathyroidism, Infection.
