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NYCC MSP > Intro to Neoplasia of Bone Tissues > Flashcards

Intro to Neoplasia of Bone Tissues Flashcards

1
Q

Mutations of what types of genes contribute to cancer genetics?

A
  • oncogenes
  • tumor suppressor genes
  • anti-apoptotic/pro-apoptotic genes
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2
Q

What is the result of mutated oncogenes?

A

increased cell proliferation
(turns on oncogenes, should be quiescent)

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3
Q

What is the function of tumor suppressor genes?

A

decrease uncontrolled proliferation

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4
Q

___-apoptotic genes would be present in a malignant neoplasia

A

anti-apoptotic (stop cells from dying)

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5
Q

____-apoptotic genes are involved in fighting against a malignant neoplasia

A

pro-apoptotic (make cells die)

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6
Q

What pathologies are risk factors for neoplasia of bone?

A
  • Paget disease
  • Chronic infection (osteomyelitis)
  • Fibrous dysplasia (<1%)
  • Some benign tumors (eg. osteochondroma -> osteosarcoma)
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7
Q

Patients with Pagets disease are particularly at risk of developing what malignant neoplasia?

A

osteosarcoma

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8
Q

What is the bimodal distribution of osteosarcoma?

A
  • usually <25 yrs
  • > 50 yrs (Pagets/radiation)
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9
Q

Why is radiation therapy a risk factor for malignancy?

A
  • scrambles chromosome cross-linking -> cell death
  • can also turn on oncogenes & turn off tumor suppressor genes
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10
Q

Genes that produce proteins which regulate cellular replication by slowing proliferation are called ____

A

tumor suppressor genes

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11
Q

Where do primary bone tumors originate?

A

in a bone tissue cell line:
- bone
- cartilage
- fibroblast
- blood cells/vessels
- marrow
(anything that contributes to normal bone)

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12
Q

Where do the majority of primary bone tumors occur?

A

distal femur or proximal tibia (metaphyses)
(knee)

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13
Q

Secondary bone tumors are considered ____ disease

A

metastatic

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14
Q

Secondary bone tumors originate in ____ and spread to ____

A

another tissue –> bone

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15
Q

What part of bone do secondary bone tumors usually spread to?

A

marrow (nutrient-rich)

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16
Q

Describe the borders/margins of benign tumors

A
  • well-circumscribed
  • narrow/short ZoT (non-aggressive)
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17
Q

Describe the borders/margins of malignant tumors

A
  • poorly defined
  • wide/long ZoT (aggressive/invasive)
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18
Q

Benign tumors have a ____ rate of growth

A

linear
(will eventually stop)

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19
Q

Malignant tumors have a ____ rate of growth

A

exponential

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20
Q

Cells of benign tumors generally have what function?

A

tissue of origin

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21
Q

Cells of malignant tumors generally have what function?

A

replication

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22
Q

Are benign tumors generally painful?

A

usually painless, may cause adjacent tissue pain

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23
Q

Are malignant tumors generally painful?

A
  • painful/insidious onset
  • possibly other cardinal signs of inflammation
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24
Q

Are benign tumors capable of metastasis?

A

no

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25
Q

Are malignant tumors capable of metastasis?

A

yes

26
Q

Describe the prognosis of benign versus malignant tumors

A

Benign: good
Malignant: poor (depends on grade)

27
Q

Define metastatic neoplasia

A

spread of neoplastic cells from one tissue to another otherwise healthy tissue

28
Q

Define metastatic calcification

A

deposition of calcium in otherwise healthy tissue

29
Q

What are the metastatic routes of spread?

A
  • hematogenous
  • lymphatic
  • direct extension
30
Q

What is the most common metastatic route of spread? Why?

A

hematogenous
- tumors create vascular supply (angiogenesis)
- O2 + glucose available
- malignant cells shed easily -> into bloodstream

31
Q

Why are the lumbar spine and pelvis a common area of metastasis?

A
  • ^^blood in area
  • gravity
  • Batson’s venous plexus (no valves)
32
Q

What are the lab findings of benign tumors of bone?

A

normal

33
Q

What are the radiographic characteristics of benign tumors of bone?

A

non-aggressive:
- no soft tissue involvement
- cortex (usually) intact
- periosteum unaffected (or solid Rxn)
- short/narrow ZoT

34
Q

How is a MALT lymphoma classified?

A

low-grade malignancy
(mucosal-associated lymphoid tissue)

35
Q

What are the lab findings of malignant tumors of bone?

A

Abnormal:
- ^ESR
- ^CRP
- anemia
- abnormal WBC counts (seen w/ recurrent infections)

36
Q

Normal ESR and CRP labs would rule out a ____ tumor

A

(aggressive) malignant

37
Q

Why would a malignant bone tumor cause anemia?

A
  • replacement of bone marrow = decreased RBCs/WBCs
  • manifests as fatigue
38
Q

What are the radiographic characteristics of malignant bone tumors?

A
  • soft tissue involvement
  • cortex disruption
  • periosteal disruption/lifting (Codman’s, laminated, spiculated)
  • long/wide ZoT
39
Q

A soft tissue mass extending beyond bone indicates a (primary/secondary) malignancy of bone

A

primary
(mets to bone rarely involves soft tissue)

40
Q

How are neoplasias of bone tissue diagnosed?

A
  • traumatic/pathologic determinism (patho Fx)
  • radiographic evidence
  • other imaging
  • tissue biopsy
41
Q

What is the only definitive diagnosis of a neoplasia?

A

tissue biopsy

42
Q

In what situation would you NOT want to get a biopsy?

A

in highly vascular tissue where there is concern of ^bleeding or spread along biopsy tract
(eg. metastatic melanoma or chondrosarcoma)

43
Q

What does the prefix of a neoplasia usually indicate?

A

tissue of origina

44
Q

What does the suffix -oma indicate?

A

benign MSK

45
Q

What does the suffix -sarcoma indicate?

A

malignant MSK

46
Q

A chondroma is a ____ tumor of ____ cells

A

benign
cartilage

47
Q

Why does neoplasia in bone tissues rarely cross open growth plates?

A
  • not much blood to physis (obtains nutrients via diffusion)
  • once growth plate closes, no longer a barrier
48
Q

A patient with a ____ primary bone tumor will frequently present with pain and possibly swelling

A

malignant

49
Q

A radiographic finding for a ____ tumor is ____.
(Select all that apply)
A) malignant; short zone of transition
B) benign; solid periosteal lifting
C) malignant; cortical disruption
D) benign; soft tissue involvement

A

B & C

50
Q

Giant cell tumors start in the ____ of bone and grow toward the ____

A

metaphysis -> epiphysis

51
Q

What benign tumors are commonly found in the epiphysis/apophysis of bone?

A
  • chondroblastoma
  • giant cell tumor
52
Q

What benign tumors are commonly found in the metaphysis of bone?

A
  • osteoid osteoma
  • osteoblastoma
  • osteochondroma
  • enchondroma
  • chondromyxoid fibroma
  • non-ossifying fibroma
  • giant cell tumor
  • aneurysmal bone cyst
53
Q

What benign tumors are commonly found in the diaphysis of bone?

A
  • enchondroma
  • fibrous dysplasia
54
Q

What bones have the potential to develop benign cartilage tumor cells?

A

any bone formed by endochondral ossification (tubular bones)

55
Q

Name 3 benign bone forming tumors

A
  • osteoma
  • osteoid osteoma
  • osteoblastoma
56
Q

Name 3 benign cartilage forming tumors

A
  • osteochondroma
  • chondroma
  • chondroblastoma
57
Q

What is the origin of giant cell tumors?

A

unknown origin (similar to macrophages)

58
Q

Which of the following is a radiographic characteristic of an aggressive lesion?
A) non-invasive
B) short zone of transition
C) no periosteal disruption
D) cortical destruction

A

D

59
Q

Which of the following is primarily osteoblastic and would result in a radiopaque appearance?
A) aneurysmal bone cyst
B) osteoma
C) fibrous cortical defect
D) simple bone cyst

A

B

60
Q

Which of the following is most consistent with a non-aggressive lesion of bone?
A) laminated periosteal reaction
B) elevated ESR
C) motheaten osteolysis
D) narrow zone of transition

A

D

NYCC MSP (22 decks)

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