Histopath - neoplastic bone disease

Question 1

Most common type of bone tumour

Answer 1

Secondary bone metastases

Question 2

2 important Ix for suspected bone tumours?

Answer 2

X-Ray

Needle biopsy +/- guidance

Question 3

A malignant primary bone tumour seen commonly in older patients?

Answer 3

Chondrosarcoma

Question 4

A bone tumour which stains positive for ALP, and X-Ray show’s an elevated periosteum?
What is the latter sign called?

Answer 4

Osteosarcoma

Corman’s triangle

Question 5

Chondrosarcoma - X-ray features?

Answer 5

Lytic lesion + FLUFFY CALCIFICATION

Question 6

Osteosarcoma - most common site?

Answer 6

Knee

Question 7

t(11;22) associated with which bone tumour?

Answer 7

Ewing’s sarcoma

Question 8

Histology of a bone tumour shows sheets of small round cells

Answer 8

Ewing’s sarcoma

Question 9

Immunohistochemistry shows CD99 +ve and MIC-2 +ve

Answer 9

Ewing’s sarcoma

Question 10

Which bone tumour is borderline btw malignant and benign? What is seen on histology?

Answer 10

Giant cell tumour

Osteoclast-like giant cells + spindle/ovoid cells

Question 11

Histology shows Osteoclast-like giant cells + spindle/ovoid cells

Answer 11

Giant cell tumour

Question 12

Tumours likely to metastasise to bone?

Answer 12

Breast, prostate, lung, kidney

Question 13

If tumour affects multiple bones, is it likely to be benign or malignant?

Answer 13

Benign, otherwise secondary mets

Question 14

Bony outgrowth with cartilage capped over it?

Answer 14

Osteochondroma

Question 15

Which bones are affected by osteochondroma

Answer 15

Long bones

Question 16

Which benign bone tumour tends to affect the hands?

Answer 16

Endochondroma

Question 17

Benign bone tumour of cartilaginous origin WITHIN bone?

Answer 17

Enchondroma

En the bone

Question 18

Which bone tumour is associated with GNAS mutation?

Answer 18

Fibrous dysplasia

Question 19

Shepherd’s crook deformity - what is it and in which disease is it seen?

Answer 19

X-ray sign showing deformity of the femoral head, seen in fibrous dysplasia

Question 20

Soap bubble osteolysis

Answer 20

Fibrous dysplasia

Question 21

Bone forming benign bone tumours:

• which one affects the leg?
• Which one affects head and neck?

Answer 21

Leg: Osteoid osteoma

Head + neck: Osteoma

Question 22

Histology shows chinese letters - which bone tumour is this?

Answer 22

Fibrous dysplasia

Question 23

X-ray shows speckled mineralisation - what bone tumour is this?

Answer 23

Osteoblastoma

Question 24

Define a soft tissue tumour

Answer 24

Mesenchymal proliferation of tissue that is extra skeletal and non-epithelial§

Question 25

What factors would indicate a good prognosis for a soft tissue tumour

Answer 25

<5cm
No vascular involvement
Low grade dysplasia
Clear margins
\+ve TS gene and -ve promotor gene

Question 26

Which malignant bone tumour tends to affect the axial skeleton?

Answer 26

Chrondrosarcoma