Dag 2 Flashcards
Bony swelling of the proximal humerus in a young patient. The most likely diagnosis is:
- chondrosarcoma
- chondroblastoma
- fibrous dysplasia
- broad-based osteochondroma
- eosinophilic granuloma
- broad-based osteochondroma
A 57-year-old male presents with neck pain and headache. Facial nerve palsy is found on physical examination. Sagittal T1-weighted MR showed a hypointense masse measuring 5x4x4.5 cm centered in the clivus. A transoral biops was performed and showed a tumor with lobulated architecture and abundant extracellular matrix. The tumor cells show abundant, vacuolated cytoplasm. Immunohistochemistry for keratin and brachyury is positive. These findings ars most typical for
- Chondrosarcoma
- Enchondroma
- Benign notochordal cell tumor
- Chordoma
- Chondroblastoma
- Chordoma
20-year old patient with complaints of proximal humerus. Plain radiograph and axial T2-weighted (water sensitive) MR image representing a lesion. Which of the following statements is right?
- based on the age and radiographic appearance chondrosarcoma is the most likely diagnosis
- based on location, age of the patient and radiographic appearance osteosarcoma is the most likely diagnosis
- the radiographic appearance and surrounding edema on MRI (high on T2) is consistent with osteomyelitis
- the radiographic appearance and surrounding edema is consistent with chondroblastoma
- this is certainly a benign lesion because there is no soft tissue extension
- the radiographic appearance and surrounding edema is consistent with chondroblastoma
Adult patient with condroid lesion of the middle phalanx and fracture. Plain radiographs in AP and lateral direction. Which of the following statements is not valid?
- without cortical destruction and soft tissue swelling, low-grade chondrosarcoma in a phalanx is not a likely diagnosis
- enchondroma is the most commonly encountered bone tumor in a phalanx
- enchondromas in phalanges may present as lucent lesions without any calcifications
- a fracture after a minor trauma is a common presentation of an enchondroma of the hand
- MR imaging should always be performed in patients with chondroid lesions of the phalanges
- MR imaging should always be performed in patients with chondroid lesions of the phalanges
32-year old patient with pain of the left knee. Plain radiographs and axial T2-weighted MR image are shown. Which answer is right?
- based on the location and age of the patient chondroblastoma is the most likely diagnosis
- based on the location and age of the patient giant cell tumor is the most likely diagnosis
- the low signal intensity on T2 and surrounding edema (high signal) makes a diagnosis of chondroblastoma or giant cell tumor unlikely
- based on the radiographic appearance, age and MRI aneurysmal bone cyst is most likely diagnosis
- based on the radiographic lesional margins, this is certainly a malignant bone tumor
- based on the location and age of the patient giant cell tumor is the most likely diagnosis
Conventional osteosarcoma is characteristically defined as
- A malignant, bone-forming neoplasm that arises on the surface of bone
- A low-grade malignant bone-forming tumor that arises within the medullary cavity of bone
- A malignant neoplasm in which the neoplastic cells produce bone
- A malignant hyaline cartilage neoplasm
- A bone-forming neoplasm that produces woven bone spicules, which are bordered by prominent osteoblasts
- A malignant neoplasm in which the neoplastic cells produce bone
A 21 year old man presented with a painful increasing swelling of the lower leg. Images and histology are shown below. What is the most likely diagnoses?
- Unicameral Bone Cyste
- Osteosarcoma
- Ewing Sarcoma
- Aneurysmal Bone Cyste
- High grade Chondrosarcoma
- Aneurysmal Bone Cyste
Classic adamantinoma of long bone occurs in the diaphysis of long bones. Histologically, this lesion is characteristcally composed of
- Epithelial cells embedded in a cellular fibrous proliferation
- Osteoblasts depositing mature lamellar bone admixed with osteoclasts
- Osteoclast-like giant cells in a background of mononuclear cells
- Small round cells with a diffuse growth pattern
- Spindle-shaped cells depositing woven bone
- Epithelial cells embedded in a cellular fibrous proliferation
12 year old girl with pain on the posteromedial side right knee. No fever, no trauma, severe nightpain. X-ray, MRI and histology are shown. What is the most likely diagnoses
- Unicameral Bone Cyste
- Osteomylitis
- Fibrous dysplasia
- Chondroblastoma +/- Aneurysmal Bone Cyste
- Chondrosarcoma
- Chondroblastoma +/- Aneurysmal Bone Cyste
34 year old man with mild pain in the right thigh, no fever no swelling, no night pain. X-ray, MRI, and Histology are shown. What is the most likely diagnoses?
- Chondroblastoma
- Osteomyelitis
- Osteosarcoma
- Enchondroma
- High grade Chondrosarcoma
- Enchondroma
Which of the following tumors is associated with IDH1 or IDH2 mutations?
- Osteochondromas
- Enchondromas
- Osteoid osteoma
- Osteoblastoma
- Chondroblastoma
- Enchondromas
You work in a sarcoma center. This 13 yr old boy has pain in his left hip. What is true about this lesion:
- You must get a “, it might be malignant and you should order an MRI
- It looks benign, a “no-touch” lesion and you should not do anything
- It may be an osteoid and you first order a CT
- It may be an osteoid osteoma and you first order an MRI
- It may be a metastasis and you order a chest x-ray and do bloodtests
- It may be an osteoid and you first order a CT
What is the preferred route of biopsy?
- 1
- 2
- 3
- 4
- 5
- 3
What biopsy route can be used?
- 1
- 2
- 3
- 4
- 1 and 3 can both be used
- 1 and 3 can both be used
A 56 year old man has spontaneous pain in his roght hip, no trauma. Past medical history is unremarkable except for prostatitis. He had fysiotherapy, but the pain got worse. X ray shows a lucency right proximal femur. You ordered an MRI, but before it was done, he presents with a fracture.
- You do an MRI, blood tests and plan a biopsy or consult a collegue.
- It is probably a metastasis, he is in pain, so you take him to theatre to do a biopsy and put in a femoral nail
- You first ask the medical oncologist to screen him for a primary lesion, and plan him already for biopsy and femoral nailing in 2 days so he does not have to wait too long
- You do a biopsy and wait for the result before you do anything else
- Because of his age and the lytic nature of the lesion, it is very likely multiple myeloma and he needs chemotherapie and radiation directly
- You do an MRI, blood tests and plan a biopsy or consult a collegue.