Bone Tumors

Question 1

Two most important determinant in the analysis of a potential bone tumor are:

Answer 1

1. morphology of the bone lesion on a plain radiograph

2. age

Question 2

Most useful examination for differentiating bone lesions

Answer 2

conventional radiography

Question 3

Most reliable indicator in determining

whether these lesions are benign or malignant

Answer 3

zone of transition between the lesion and the adjacent normal bone

Question 4

This is common (in differential dagnosis) to all age group and morphology.

Answer 4

Infection

Question 5

Determining the type of lesion by its zone of transition applies to osteolytic or sclerotic lesions?

Answer 5

Osteolytic

*sclerotic lesions have a narrow transition zone

Question 6

What type of transition is being described:

transition results in a sharp, well-defined border and is a sign of slow growth.

Answer 6

Small zone of transition

Question 7

Most common bone tumors In patients > 40 years.

Answer 7

Metastases and multiple

myeloma

Question 8

Type of transition being described:

1. ill-defined border with a broad zone of transition is a sign of aggressive growth
2. a feature of malignant bone tumors.

Answer 8

Wide zone of transition

Question 9

What are the two tumor-like lesions which may
mimic a malignancy and have to be included in
the differential diagnosis.

Answer 9

infections, eosinophilic granuloma

*these two are may have an aggressive growth pattern but are actually benign.

Question 10

Describe appearance of infections and eosinophilc granuloma.

Answer 10

Ill-defined margins, but
cortical destruction and an aggressive type of
periosteal reaction may also be seen; benign.

Question 11

Non-specific reaction

and will occur whenever the periosteum is irritated by a malignant tumor, benign tumor, infection or trauma.

Answer 11

Periostal reaction

Question 12

Two patterns of preiosteal reaction.

Answer 12

Benign and an aggressive type

Question 13

Benign type is seen in benign lesions such
as benign tumors and following trauma.

T/F

Answer 13

True

Question 14

An aggressive type is seen in malignant tumors, but also in benign lesions with aggressive behavior, such as infections and eosinophilic
granuloma.

T/F

Answer 14

True

Question 15

Malignant lesion will cause benign periosteal reaction.

T/F

Answer 15

False

Question 16

Benign/aggresive type

1. thick, wavy and uniform callus formation resulting from chronic irritation.

Answer 16

Benign periosteal type

Question 17

1. multilayered, lamellated or demonstrates bone formation perpendicular to the cortical bone
2. Codman’s triangle

Answer 17

aggressive periosteal type

Question 18

Elevation of
the periosteum away from the cortex, forming an angle where the elevated periosteum and
bone come together.

Answer 18

Codman’s triangle

Question 19

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.

Answer 19

Ballooning

Question 20

A benign, well-defined, expansile lesion with regular destruction of cortical bone and a peripheral layer of new bone.

Answer 20

Chondromyxoid fibroma

Question 21

A locally aggressive lesion with cortical
destruction, expansion and a thin,
interrupted peripheral layer of new bone.

Answer 21

Giant cell tumor

Question 22

Two types of mineralization

Answer 22

1. a chondroid matrix in cartilaginous tumors

2. chondrosarcoma and an osteoid matrix in osseus tumors

Question 23

Matrix described as: rings-and-arcs, popcorn, focal

stippled or flocculent.

Answer 23

Chondroid matrix

Question 24

Matrix described as: trabecular ossification pattern in benign bone-forming lesions and as a cloud-like or ill-defined amorphous pattern in osteosarcomas.

Answer 24

Osteoid matrix

Question 25

Multiple osteolytc lesions: FEEMHI

Answer 25

Fibrous dysplasia, enchondromas, EG, Mets and myeloma, Hyperparathyroidism, Infection.