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Dx Imaging II > Exam 3 Tumors > Flashcards

Exam 3 Tumors Flashcards

1
Q

What tumor crosses the physis?

A

giant cell tumor

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2
Q

What tumor is in the epiphysis?

A

chondroblastoma

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3
Q

Age of occurrence for Ewing’s Sarcoma?

A

10-25

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4
Q

Age of occurrence for osteosarcoma?

A

10-25

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5
Q

Age of occurrence for Giant Cell Tumor?

A

20-40

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6
Q

Age of occurrence for chondrosarcoma?

A

55-70

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7
Q

Age of occurrence for myeloma?

A

50-70

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8
Q

75% of all malignancies?

A

metastatic disease

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9
Q

MC primary malignant tumor in in adults?

A

multiple myeloma

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10
Q

MC primary malignant tumor in kids?

A

osteosarcoma

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11
Q

MC benign osseous tumor?

A

osteochondroma

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12
Q

MC benign spinal tumor?

A

hemangioma

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13
Q

More aggressive tumors have ________ zone of transition.

A

longer

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14
Q

Most aggressive forms of periosteal reaction?

A

Codman’s Triangle

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15
Q

Tumors with cartilage matrix 5:

A
  1. enchondroma
  2. osteochondroma
  3. chondroblastoma
  4. chondromyxoid fibroma
  5. chondrosarcoma
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16
Q

Tumors with osseous matrix 5:

A
  1. osteoma
  2. osteoblastoma
  3. osteochondroma
  4. osteoid osteoma
  5. osteosarcoma
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17
Q

Tumors with fibrous matrix 6:

A
  1. fibrous dysplasia
  2. desmoplastic fibroma
  3. non-ossifying fibroma
  4. fibrous cortical defect
  5. ossifying fibroma
  6. fibrosarcoma
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18
Q

bone expansion typically primary, >6cm, numbers of lesions, periosteal reaction, presence of ST

A

primary neoplasia

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19
Q

MC sites of metastatic bone disease:

A

breast, lung, prostate, kidney, thyroid, and bowel

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20
Q

Types of metastatic bone disease:

A

blastic, lytic, mixed, or expansile

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21
Q

MC primary site for mets in females:

A

breast (70%) 80% is lytic and 10% is blastic

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22
Q

MC primary site for metastasis in males:

A

prostate (60%) 80% blastic

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23
Q

MC pathway of metastasis?

A

hematogenous dissemination (blood)

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24
Q

MC secondary sites of metastasis:

A 
Spine 40%
Ribs and sternum 28%
Pelvis and sacrum 12%
Proximal extremities 10%
Skull 10%
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25
Q

Where is metastasis rare?

A

distal to knees and elbows

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26
Q

Radiographic features of vertebral metastasis:

A

ivory vertebra, pedicle destruction, pathologic collapse, focal osteoporosis of a body, and malignant schmorl’s node formation

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27
Q

Solitary ivory vertebra most likely indicates:

A
  1. Paget’s
  2. Hodgkin’s lymphoma
  3. Osteoblastic metastasis
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28
Q

What lab is helpful when checking for lymphoma?

A

CBC, BCP, and ESR

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29
Q

What lab is helpful when checking for Paget’s?

A

BCP for alkaline phosphatase

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30
Q

What lab is helpful when checking for blastic mets?

A

BCP to include alkaline and acid phosphatase and PSA

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31
Q

MRI characteristics of metastasis:

A

T1 sensitive: low

T2 variable: high

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32
Q

Primary malignant neoplasia accounts for ______ of all malignancies:

A

30%

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33
Q

Age for multiple myeloma:

A

50-70

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34
Q

Round cell tumors:

A
  • Ewing’s
  • Non-Hodgkin’s lymphoma
  • Multiple myeloma
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35
Q

Clinical features of multiple myeloma:

A

pain, unexplained wt loss, cachexia, bacterial respiratory infections, anemia, renal disease, respiratory disease, deossification of bone, abnormal serum and urine proteins

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36
Q

Lab findings for multiple myeloma:

A

elevated ESR, thrombocytopenia, rouleaux formation, increased serum Ca, normal to increased serum phosphorus, M Spike on protein electrophoresis

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37
Q

Skeletal locations for multiple myeloma:

A

vertebrae: thoracic and lumbar, pelvis, skull, ribs, clavicle, scapula, femur, and humerus

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38
Q

What is solitary plasmacytoma?

A

localized form of plasma cell proliferation

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39
Q

What areas does solitary plasmacytoma prefer?

A

vertebra>pelvis>skull>sternum>ribs

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40
Q

Soap bubbly, highly expansile lesion:

A

solitary plasmacytoma

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41
Q

Bone scan on multiple myeloma:

A

may be normal

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42
Q

Rain drop skull:

A

multiple myeloma

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43
Q

Multiple myeloma may spare the _________ more than lytic mets:

A

pedicles

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44
Q

5 yr survival multiple myeloma:

A

20%

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45
Q

Primary malignant tumor of undifferentiated CT which forms neoplastic osteoid:

A

osteosarcoma

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46
Q

2nd MC primary malignant bone tumor:

A

osteosarcoma

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47
Q

MC primary malignant bone tumor in children and young adults:

A

osteosarcoma

48
Q

Age for osteosarcoma:

A

10-25 and 60+

49
Q

Clinical presentation for osteosarcoma:

A

painful swelling 85% of the time

50
Q

Skeletal location of osteosarcoma:

A

distal femur: 40%
proximal tibia: 16%
proximal humerus: 15%
(75% in metaphysis next to growth plate)
(cylindrical bones under 30 and flat bones over 50)

51
Q

Mets from osteosarcoma to:

A

lungs

52
Q

Rad findings for osteosarcoma:

A
  • ill defined, dense sclerotic lesion >5cm fills medullary space
  • moth eaten medullary and cortical destruction less C
  • sunburst/Codmans
  • large ST mass w tumor
53
Q

Cumulus cloud, cannonball:

A

osteosarcoma

54
Q

What films are needed with osteosarcoma:

A

chest films/CT

55
Q

Secondary osteosarcoma:

A

Paget’s, Ollier’s, Ionizing radiation, Polystotic fibrous dysplasia, Hereditary multiple exostosis

56
Q

Third most common primary malignant bone tumor:

A

chondrosarcoma

57
Q

Secondary chondrosarcoma:

A

complication of preexisting skeletal abnormality such as osteochondroma or enchondroma

58
Q

Age for chondrosarcoma:

A

40-60

59
Q

Common locations for chondrosarcoma:

A

proximal humerus, neck of femur, ribs, sternum, pelvis

60
Q

Popcorn matrix calcification:

A

chondrosarcoma (also fluffy, stippled, cotton wool, etc)

61
Q

4th most common primary malignant bone tumor:

A

Ewing’s Sarcoma

62
Q

2nd most common primary malignant bone tumor in children:

A

Ewing’s Sarcoma

63
Q

Age for Ewing’s Sarcoma:

A

10-25, peak at 15

64
Q

Clinical Ewing’s:

A

severe localized pain, palpable soft tissue mass, fever, infection

65
Q

Only primary malignant tumor that stimulates infection:

A

Ewing’s

66
Q

Skeletal location for Ewing’s:

A

long tubular bones: 60% (femur, tibia, humerus, fibula, especially under 20)

67
Q

onion skin

A

Ewing’s Sarcoma

68
Q

Saucerization:

A

Ewing’s

69
Q

Most common primary malignancy to metastasize to bone:

A

Ewing’s

70
Q

Ewing’s metastasis:

A

lung, bone, regional lymph nodes (11-30% at diagnosis, 40-45% within 2 years)

71
Q

Ewing’s 5 year survival:

A

60-75%

72
Q

Giant Cell Tumor: Benign or Malignant?

A

quasi-malignant malignant 20% of time

73
Q

Age for Giant Cell tumors:

A

20-40

74
Q

Osseous location of GCT:

A

85% in long bones (distal femur, proximal tibia(50-60%), distal radius, and proximal humerus)

75
Q

GCT tumors are more malignant in:

A

distal radius

76
Q

GCT clinical:

A

local aching pain, malignant more in males

77
Q

bony exostosis on external bone with a hyaline cartilage cap:

A

solitary osteochondroma

78
Q

Most common benign osseous tumor:

A

solitary osteochondroma

79
Q

50% of all benign tumors:

A

solitary osteochondroma

80
Q

age for solitary osteochondroma:

A

under 20

81
Q

Clinical solitary osteochondroma:

A

asymptomatic unless disturbing vessels or nerves. Painless hard mass. Pain or new growth may mean malignant

82
Q

Osseous location solitary osteochondroma:

A

metaphysis of long bones: femur, tibia (50%), humerus, proximal radius

83
Q

Growth of solitary osteochondroma stops when:

A

growth plate closes

84
Q

Exostosis on solitary osteochondroma grows:

A

away from joint

85
Q

Widespread solitary osteochondroma:

A

hereditary multiple exostosis

86
Q

mushroom shaped peduculated bony excresence:

A

sessile osteochondroma

87
Q

Hereditary multiple exostosis AKA:

A

diaphyseal achalasia

88
Q

HME age:

A

2-10

89
Q

Average exostosis in HME:

A

10

90
Q

HME clinical:

A

painless hard masses, cord compression possible, malignant 5-20%(chondrosarcomas)

91
Q

SBC age:

A

3-14

92
Q

SBC location:

A

60-75% in proximal humerus and femur

93
Q

Fallen fragment sign:

A

SBC

94
Q

Age of aneurysmal bone cyst:

A

10-30 (75% below 20)

95
Q

Clinical ABC:

A

acute onset of pain increasing over 6-12 weeks, may have trauma

96
Q

Locations aneursymal bone cyst:

A

spine 30% (posterior anatomy)

long bones and flat bones

97
Q

ABC cortex:

A

invisible thin

98
Q

ABCs are not:

A

subarticular

99
Q

GCTs are:

A

subarticular

100
Q

Age osteoblastoma:

A

10-20 peak

101
Q

Osteoblastoma resembles:

A

osteoid osteoma

102
Q

Clinical osteoblastoma:

A

dull pain of insidious onset: 84%

103
Q

Osteoblastoma locations:

A

spine in 40%
long bone: 30%
small bones of hands and feet: 25%

104
Q

Osteoid osteoma represents ______ of benign tumors

A

12%

105
Q

Age osteoid osteoma:

A

10-25

106
Q

Clinical findings osteoid osteoma

A

tender to touch, local pain in 98%, worse at night, salicylates relieve pain in most

107
Q

Location osteoid osteoma

A

meta/diaphysis of long bones (73%)

108
Q

Age enchondroma:

A

10-30

109
Q

MC benign tumor of the hand

A

enchondroma

110
Q

Location endochondroma:

A

small bones of wrist and hands: 40% (phalanges>metacarpals), long bones, usually central

111
Q

enchondromatosis, early childhood, hand and foot deformity, multiple enchondromas

A

Ollier’s disease

112
Q

Age hemangiomas:

A

40-60

113
Q

Signs/symptoms of hemangiomas:

A

asymptomatic unless spinal lesions cause stenosis and compression

114
Q

Locations of hemangiomas:

A

lower thoracic and upper lumbars, calvarium (frontal)

115
Q

Accordion, corduroy, honeycomb:

A

hemangioma

Dx Imaging II (5 decks)

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