joints 2

Question 1

reactive tumor like lesions

Answer 1

ganglions
synovial cysts
osteochondral loose bodies
usually d/t trauma or degenerative process

Question 2

ganglion

Answer 2

small <1.5 cm cyst located near joint capsule or tendon sheath
common in wrist
LACKS cell lining
no communication with joint space

Question 3

synovial cyst

Answer 3

when ganglion cyst herniated into joint capsule or massive enlargement of bursa
bakers cyst- popliteal fossa in RA

Question 4

tenosynovial giant cell tumor

Answer 4

diffuse or localized type
diffuse- large joints
localized- discrete nodule attached to tendon sheath
20-40

Question 5

tenosynovial giant cell tumor Bx

Answer 5

yellow-brown tiger striping (diffuse)
localized well circumscribes
both infiltrated with macros

Question 6

tenosynovial giant cell tumor clinical

Answer 6

diffuse- 80% in knee, pain, locking, recurrent swelling

tumor progression limits ROM

Question 7

tenosynovial giant cell tumor Tx

Answer 7

surgical excision
recurrence is common
clinical trials with M-CSF antagonists encouraging

Question 8

benign vs malignant soft tissue neoplasms

Answer 8

benign 100x more common

Question 9

most common location for sarcoma

Answer 9

thigh, below fascial plane

Question 10

soft tissue tumors

Answer 10

multiple modalites required for Dx

gross, histo, genetic, biochem

Question 11

fasicles of eosinophilic spindle cells intersecting at right angles

Answer 11

smooth mm tumor

Question 12

pinwheal

Answer 12

fibrohistiocytic tumors

Question 13

nuclear pallisading

Answer 13

schwann cell tumors

Question 14

herringbone

Answer 14

fibrosarcoma

Question 15

mixture of fasicles of spindle cells and groups of epithelioid cells- biphasic

Answer 15

synovial sarcoma

Question 16

painful skin tumors

Answer 16

GLENDA
G-glomus
L-leiomyomas
E-eecrine spirolyomas
N-neuronevous
D- dermatofibroma
A-angiolipoma

Question 17

liposarcomas

Answer 17

one of most common sarcomas of adulthood

50-60 in deep soft tissues of extremities and retroperitoneum

Question 18

nodular fascitis

Answer 18

self-limited fibroblastic and myofibroblastic proliferation that typically occurs in young adutls in upper extremity with hx of trauma
can be scary cause lots of mitoses

Question 19

superficial fibromatosis

Answer 19

infiltrative fibroblastic proliferation that can cause local deformity
M>F
characterized by nodular or poorly defined borad fasicles of fibroblasts in long, sweeping fasciles, surrounded by dense collagen

Question 20

subtypes of superficial fibromatosis

Answer 20

palmar (dupuytren contracture)
plantar
penile (peyroine disease)

Question 21

palmar superficial fibromatosis

Answer 21

irregular nodular thickening of palmar fascia u/l or b/l

usually 4th and 5th digits

Question 22

plantar superficial fibromatosis

Answer 22

common in young pts

u/l w/o contractions

Question 23

penile superficial fibromatosis

Answer 23

palpable induration or mass on dorsolateral aspect of penis

eventually can abnomral curvature of shaft, constrict urethra or both

Question 24

deep fibromatosis/desmoid tumors

Answer 24

large infiltrative masses that frequently recur, but do not metastasize
teens-30’s, women

Question 25

deep fibromatosis types

Answer 25

extra-abdominal
abdominal
intra-abdominal

Question 26

extra-abdominal deep fibromatosis

Answer 26

M=W

shoulder, chest wall, back, and thigh

Question 27

abdominal deep fibromatosis

Answer 27

musculoponeurotic strucutes of ant abdominal wall

W>M during after prego

Question 28

intra-abdominal deep fibromatosis

Answer 28

mesentery or pelvic walls

familial adenomatous polyposis

Question 29

skeletal mm tumors

Answer 29

almost all malignant

benign rhadomyoma is seen in tuberous sclerosis

Question 30

subtypes of rhabdomyosarcoma

Answer 30

alveolar 20%
embryonal 60%
pleomorphic 20%

Question 31

alveolar and embryonal rhabdomyosarcoma

Answer 31

usually appear <20

most common soft tissue sarcoma of childhood and adolescence

Question 32

pleomorphic rhabdomyosarcoma

Answer 32

adults

Question 33

rrhabdomyosarcoma presentation

Answer 33

grapelike clusters of vagina, ear, eye

Question 34

Tx rhabdomyosarcoma

Answer 34

surgery, chemo, +/- radiation

pleomorphic fatal

Question 35

leiomyomas

Answer 35

benign tumor of smooth mm

often arises in uterus (most common neoplasm of women)

Question 36

pilar leiomyomas

Answer 36

erector pili mm in nipples, skin, scrotum, and labia

multiple and painful

Question 37

leiomyosarcoma

Answer 37

10-20% of soft tissue sarcomas
adults
M>W
deep soft tissues of extremities and retroperitoneum

Question 38

Dx leiomyosarcoma

Answer 38

mm specific actin immunostain of Bx

Question 39

leiomyosarcoma morphology

Answer 39

eosinophillic spindle cells with blunt-ended hyperchromatic nuclei arranged in interweaving fasciles
stain with mm actin and desmin

Question 40

leiomyosarcoma clinical

Answer 40

painless firm masses
retroperitoneal can present with abdominal issues d/t compression, poor prognosis with mets to lungs
superficial/cutaneous usually small with good prognosis

Question 41

synovial sarcoma

Answer 41

usually knee
biphasic with glandular and spindle cells
Ca present

Question 42

synovial sarcoma presentation

Answer 42

knee, chest wall, head, neck (dont need to be in synovium)
20-40
deep seated mass present for several years

Question 43

synovial sarcoma Tx

Answer 43

aggressively with limb-sparing surgery and chemo

common sites for mets: lungs and regional lymph nodes

Question 44

undifferentiated pleomorphic sarcoma

Answer 44

high grade pleomorphic cells cannot be classifed
most arise in thigh in middle-aged/older pts
pinwheal/storiform pattern

Question 45

malignant fibrous histiocytoma

Answer 45

now known to be same as pleomorphic sarcoma

giant cell histo

Question 46

fibrosarcoma

Answer 46

herringbone pattern