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Pathology II > Diseases of Bone- Malignancies > Flashcards

Diseases of Bone- Malignancies Flashcards

1
Q

metastatic carcinoma is the most common neoplasm _____

A

located in bone

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2
Q

multiple myeloma is the most common malignant neoplasm _____

A

arising within bone

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3
Q

osteosarcoma is the most common malignant neoplasm _____

A

arising from bone

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4
Q

what are the intra osseous malignant neoplasms

A
  • metastatic carcinoma
  • multiple myeloma
  • osteosarcoma
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5
Q

which of the intraosseous malignant neoplasms are primary and which is secondary

A
  • metastatic carcinoma: secondary
  • multiple myeloma: primary
  • osteosarcoma: primary
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6
Q

describe osteosarcoma

A
  • a malignant neoplasm in which either bone or osteoid is directly produced by the malignant stroma
  • osteosarcoma may also produce
  • chondroid: chondroblastic osteosarcoma
  • collagen: fibroblast osteosarcoma
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7
Q

where are the sites of osteosarcom

A
  • most common site is long bones around knee
  • head and neck less than 10%
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8
Q

what are the signs and symptoms of osteosarcoma

A
  • pain- earliest symptom
  • swelling
  • pain and swelling - 50%
  • frequent history of dental extraction
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9
Q

what is the radiographic appearance of osteosarcoma

A
  • lytic or sclerotic
  • ill defined margins
  • variable sunburst pattern- osteophytes
  • variable localized symmetrical widening of periodontal ligament space (PDL)
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10
Q

what is the disease associated with generalized widening of the PDL space

A

scleroderma

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11
Q

what is the disease associated with localized widening of PDL

A

osteosarcoma

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12
Q

what is the treatment and prognosis of osteosarcoma

A
  • combination surgery and chemotherapy
  • neo-adjuvant (peroperative) chemotherapy
  • radical surgical resection
  • adjuvant (postoperative) chemotherapy
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13
Q

describe bone neoplasia in paget disease and what is the most common sarcoma complication of paget disease

A
  • pagetic bone exhibits higher incidence of benign and malignant neoplasms
  • osteosarcoma is the most common sarcoma complication paget disease
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14
Q

describe post irradiation bone sarcoma

A
  • frequency realted to radiation dose
  • osteosarcoma most common type of post irradiation sarcoma
  • fibrosarcoma and chondrosarcoma
  • histologic features and prognosis identical for de novo tumors
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15
Q

what is the definition of chondrosarcoma

A
  • a malignant neoplasm in which cartilage is directly produced by the malignant stroma
  • osteoid is not produced
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16
Q

is chondrosarcoma more common in maxilla or mandible

A

maxilla

17
Q

what is radiographic presentation of chondrosarcoma

A

widening of PDL
- radiopacity

18
Q

describe ewing sarcoma symptoms and predilection

A
  • young people 5-20 years
  • pain and swelling
  • constitutional symptoms- may mimic an inflammatory process
  • mimics infection with fever, leukocytosis, elevated ESR
  • pelvis and lower extremity are the most common sites; rare in craniofacial bones
19
Q

what is radiographic appaerance of ewing sarcoma

A
  • osteophytic periosteal reaction/sunburst pattern
  • onion skin periosteal reaction
  • root resorption
20
Q

what is the histo for ewing sarcoma

A
  • “blue dot disease”
  • stain is CD99 and stains brown if positive
21
Q

what is the chromosomal translocation in ewing sarcoma

A

85% of ES/PNET exhibit 11;22

22
Q

translocation can be detected by:

A

fluorescent in-situ hybridization (FISH)

23
Q

what is the treatment and prognosis of ewing sarcoma

A
  • systemic chemotherapy followed by local therapy (surgery or radiation therapy)
  • 50% five year survival in the absence of metastasis
24
Q

describe mulitple myeloma features and predilection

A
  • older adults
  • disseminated neoplasm of terminally- differentiated B lymphocytes (plasma cells)
  • multifocal lytic bone lesions, hypercalcemia, bone pain
  • myelophthisic acemia, predisposition to infections
25
Q

what are the oral findings in mulitple myeloma

A
  • lytic lesions
  • loose teeth
  • pain
  • paresthesia
  • pathologic fracture
  • macroglossia- amyloidosis
26
Q

what is the immunofluorescne with multiple myeloma

A
  • congo red stain
  • apple green appearance with amyloid presence
27
Q

what are the histo stains for multiple myleoma

A
  • kappa and lambda light chains
  • will stain for one or the other not both
28
Q

what are the lab findings in multiple myeloma

A
  • elevated serum calcium, protein, immunoglobulin
  • eleavted erythrocyte sedimentation rate
  • rouleaux formation
  • monoclonal gammopathy- M spike
  • bence jones proteinuria- immunoglobulin light chains
29
Q

what are the complications of mulitple myeloma

A
  • renal failure
  • infection
  • anemia
30
Q

biopsy of secondary metastatic lesion will look like:

A

primary lesion

31
Q
A

Pathology II (19 decks)

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