Histo: Neoplastic Bone Disease Flashcards
Which part of the body is most commonly affected by neoplastic bone disease?
Around the knee joint
Outline some presenting features of neoplastic bone disease.
- Pain
- Swelling
- Deformity
- Fracture
How are bone tumours diagnosed
X-ray
Biopsy
What type of biopsy is often used for diagnosing neoplastic bone disease?
- Needle biopsy using a Jamshidi needle under CT or US guidance
- Open biopsy for sclerotic or inaccessible lesions
List some tumour-like conditions of the bone.
- Fibrous dysplasia
- Metaphyseal fibrous cortical defect/non-ossifying fibroma
- Reparative giant cell granuloma
- Ossifying fibroma
- Simple bone cyst
What is fibrous dysplasia? Which age does it affect? What bone does it affect?
- Condition in which fibrous tissue replaces normal bone tissue
- Can occur in any bone but ribs and proximal femur is most common
- Tends to affect adolescents
Which eponymous syndrome is characterised by polyostotic fibrous dysplasia?
McCune Albright Syndrome: polyostotic fibrous dysplasia + endocrine problems + rough border café-au-lait spots
Which mutation causes fibrous dysplasia?
GNAS mutation Chr 20 q13 (mutation in a G-protein)
Describe the histological appearance of fibrous dysplasia.
The marrow is replaced by fibrous stroma with rounded trabecular bone (‘Chinese letters’)
![](https://s3.amazonaws.com/brainscape-prod/system/cm/516/298/537/a_image_thumb.png?1568555411)
Describe the deformity seen on X-ray of fibrous dysplasia of the femoral head. What other lesion might you see?
Shepherd’s crook deformity
Soap bubble appearance of lytic lesions
![](https://s3.amazonaws.com/brainscape-prod/system/cm/516/298/540/a_image_thumb.png?1568555460)
List three types of cartilaginous benign bone tumour.
- Osteochondroma
- Enchondroma
- Chondroblastoma
List three types of bone-forming benign bone tumour.
- Osteoid osteoma
- Osteoma
- Osteoblastoma
What are osteochondromas and which bones tend to be affected?
- A benign overgrowth of cartilage and bone that tends to happen at the ends of long bones
- Most common site is distal end of femur
- They mimic normal tubular bone as they have a cartilaginous surface overlying normal trabecular bone
![](https://s3.amazonaws.com/brainscape-prod/system/cm/516/298/544/a_image_thumb.png?1568555651)
What is an enchondroma and which bones tend to be affected? What may an XR show?
- A cartilaginous proliferation within the bone
- Most tend to be found in the hands and can cause pathological fractures
- X-ray may show popcorn calcification
![](https://s3.amazonaws.com/brainscape-prod/system/cm/516/298/546/a_image_thumb.png?1568555629)
What are two macroscopic features of benign bone tumours?
- Well demarcated
- May erode through the cortex of bone but does not burst through the cartilaginous surface
![](https://s3.amazonaws.com/brainscape-prod/system/cm/516/298/548/a_image_thumb.png?1568555815)