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Y4: Rheumatology > Bone Tumours > Flashcards

Bone Tumours Flashcards

1
Q
A
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2
Q

What is this?

Describe what you see?

A
  • Compact bone
    • Osteocytes are the white cells
    • Haversian systems surround the osteocytes
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3
Q

What is this?

Describe what you see

A
  • Cancellous bone
    • arranged in trabeculae
    • white spaces are marrow cavity
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4
Q

What type of bone is seen in childhood fractures and bone tumours?

A

Woven bone

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5
Q

What type of cells form woven bone?

A

Osteoblasts

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6
Q

How common are secondary bone tumours?

A

Very common

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7
Q

How common are bone myelomas?

A

Most common primary bone tumour

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8
Q

How common are primary bone tumours?

A

Rare

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9
Q

What type of cancers metastasise to bone?

A
  • Lung (bronchus)
  • Breast
  • Prostate
  • Kidney
  • Thyroid (follicular)
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10
Q

What are the childhood cancers which metastasise to bone?

A
  • Neuroblastoma
  • Rhabdomyosarcoma
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11
Q

What are the effects of cancer metastasis to bone?

A
  • Asymptomatic
  • Bone pain
  • Hypercalcaemia
  • Pathological fracture of long bones
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12
Q

What are the effects of cancer metastasising to the spine?

A
  • Back pain
  • Vertebral collapse
  • Spinal cord compression
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13
Q

Describe PET CT?

A
  • Anatomical detail can be achieved alongside functional data
    • e.g. this is a metastatic deposit in femur
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14
Q

What are the different types of bone mets?

A
  • Lytic (majority)
  • Sclerotic
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15
Q

What is this?

A
  • X-ray of lytic bone metastasis
  • Translucent area on pelvis
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16
Q

What is the mechanism of bone destruction caused by bony mets?

A
  • Osteoclasts
  • Stimulated by cytokines released from tumour cells
  • Inhibited by bisphophonates
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17
Q

Waht is pictured here?

A
  • Sclerotic bone mets
  • Opacification of left pubis
    • Likely to be from prostate cancer
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18
Q

What can sclerotic bone mets be caused by?

A
  • Carcinoid tumour
  • Breast carcinoma
  • Prostatic carcinoma
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19
Q

How do sclerotic metastasis form on bone?

A

Reactive bone formation induced by tumour cells

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20
Q

Describe solitary bone mets?

A
  • Renal and thyroid carcinomas
  • Long survival
  • Surgical removal
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21
Q

Describe Myeloma?

A
  • Most common malignant primary bone tumour
  • Monoclonal proliferation of plasma cells
  • Solitary or multiple myeloma
22
Q

What is another name for a solitary myeloma?

A

Plasmacytoma

23
Q

What are the clinical effects of myeloma?

A
  • Bone lesions
    • Punched out lytic foci
    • Osteopenia
  • Marrow replacement
    • Anaemia
    • Infectious
  • Immunoglobulin excess
    • ESR > 100
    • Bence Jones protein in urine
24
Q

What is this?

A
  • ‘Pepper pot’ skull
  • Punched out foci
  • Classical feature of myeloma
25
Q

Describe histoloy of plasma cells?

A
  • Eccentric nucleus
    • Clock face
  • Clear area on cytoplasm
26
Q

What is pictured here?

A
  • Histology of meyloma
    • Lots and lots of plasma cells
27
Q

What are the Benign Primary Bone tumours?

A
  • Chondroma
  • Giant cell tumour
  • Osteoid osteoma
28
Q

What are the Malignant Primary Bone tumours?

A
  • Osteosarcoma
  • Ewing’s tumour
  • Chondrosarcoma
29
Q

Describe Osteoid Osteoma?

A
  • Osteoblastic prolfieration
  • Spine and long bones
  • Pain, worse at night
    • Relieved by aspirin
30
Q

What is pictured here?

A

Classical radiological appearance of Osteoid Osteoma

31
Q

Describe Osteosarcoma?

A
  • Metaphysis of long bones
    • Around the knee
  • Early lung metastasis
32
Q

Classical

A

Classical presentation of (left) Osteosarcoma

33
Q

What is the prognosis of Osteosarcoma?

A

50-60% 5 year suvival now than chemotherapy has been developed

34
Q

What are the worse prognosis variants of osteosarcoma?

A
  • Paget’s disease
  • Multifocal osteosarcoma
  • Post-irradiation osteosarcoma
35
Q

What is this?

A
  • Bad osteosarcoma on x-ray
    • humerus
36
Q

Describe Paget’s disease?

A
  • Disorder of excessive bone turnover
  • Structurally weak bone
37
Q

Who does Paget’s disease commonly affect?

What bones does Paget’s disease commonly affect?

A

Elderly, anglo-saxon

  • Skull
  • Pelvis
  • Femur
  • Vertebrra
38
Q

Describe the clinical manifestations of Paget’s disease?

A
  • Bone pain
  • Deformity of long bones
  • Pathological fractures
  • Osteoarthritis
  • Deafness
  • Spinal cord compression
  • Cardiac failure due to high CO
  • Paget’s sarcoma
39
Q

Describe Paget’s sarcoma?

A
  • Second osteosarcoma peak in elderly
  • Lytic
  • Long bones
  • Very poor prognosis due to early metastases to lung and bone
40
Q

Name the bone forming tumours?

A
  • Osteoid osteoma (benign)
  • Osteocarcoma (malignant)
41
Q

Name the cartilaginous tumours?

A
  • Enchondroma (benign)
  • Osteocartilaginous exostosis (benign)
  • Chondrosarcoma (malignant)
42
Q

Describe Enchondroma?

A
  • Lobulated cartilage within medulla
  • Hands, feet, long bones
  • Low cellularity
  • Surrounded by plates of lamellar bone
43
Q

What are the symptoms of Enchondroma affected the long bones?

A

Asymptomatic

44
Q

What are the symptoms of Enchondroma affected the hands?

A
  • Swelling
  • Pathological fracture
45
Q

Describe Osteocartilaginous exostosis?

A
  • Cartilage with endochondral ossification
  • Cartilage cap
  • Derived from growth plate
46
Q

Describe Multiple-diaphyseal aclasis?

A
  • Autosomal dominant
  • Multiple osteocartilaginous exostosis
47
Q
A

Osteocartilaginous exostosis

48
Q

Describe Chondrosarcoma?

A
  • Malignant cartilage tumour
  • Primary or secondary to beign cartilage tumour
  • Withhin medullary canal or on bone surface
49
Q

Where do Chondrosarcomas tend to affect?

A
  • Ribs
  • Pelvis
  • Shoulder girdle
50
Q
A
  • Chondrosarcoma
    • chalky calcifications
51
Q

Describe Ewing’s sarcoma?

A
  • Tends to be in children
  • Long bones, flat bones
  • Early metastasis to lung, bone, marrow
  • 50-60% 5 year survival
52
Q

Name the genetic abnormality involved in Ewings sarcoma?

A

11:22 translocation

Y4: Rheumatology (19 decks)

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