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Musculoskeletal Radiology > Malignant Bone And Soft Tissue Tumors > Flashcards

Malignant Bone And Soft Tissue Tumors Flashcards

1
Q

Four aspects of a lesion to be examined

A

Cortical destruction, periostitis, orientation or axis of the lesion, zone of transition

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2
Q

Aspect of lesion that is accurate in detecting malignancy 90% of the time

A

Zone of transition

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3
Q

Periosteal reaction of most benign type

A

Callus formation

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4
Q

Slow-growing benign tumor will cause what appearance of periostitis because it is a low grade chronic irritation that gives the periosteum time to lay down thick new bone and remodel into more normal cortex

A

Thick, wavy, uniform or dense periostitis

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5
Q

Appearance of malignant periostitis

A

Lamellated (onion-skinned) of amorphous or even sunburst-like

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6
Q

The only way a benign periostitis can occur in a malignant lesion is if there is a

A

Concomitant fracture or infection

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7
Q

Zone of transition is defined as

A

Border of the lesion with the normal bone

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8
Q

Zone of transition is narrowed, if it appears

A

Well-defined

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9
Q

Zone of transition is wide, if it appears

A

Imperceptable and cannot be clearly drawn at all

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10
Q

Permeative lesions are often seen in what malignant tumors

A

Multiple myeloma, primary lymphoma of bone (reticulum cell sarcoma) and Ewinh sarcoma

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11
Q

Permeative lesions can also be seen in what benign lesions

A

Infection and EG

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12
Q

Childhood primary malignant tumors of the bone

A

Osteosarcoma and Ewing sarcoma

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13
Q

Malignant tumors after age 40

A

Metastatic disease, myeloma, chondrosarcoma

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14
Q

Malignant bone tumors in ages 30-40

A

GCT, parosteal sarcoma, malignant fibrous histiocytoma, first degree lymphoma of bone

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15
Q

Almost all malignant tumors in MRI will present as

A

Low signal in T1, high signal on T2

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16
Q

Most common malignant primary bone tumor

A

Osteosarcoma

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17
Q

Osteosarcoma in the 6th decade are probably because of

A

Secondary osteosarcoma in Paget disease and because of prior radiation

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18
Q

Lytic form of osteosarcoma

A

Telangiectatic osteosarcoma

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19
Q

General appearance of osteosarcoma in MR

A

Large soft tissue component with heterogeneous high and low signal intensities on both T1 and T2

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20
Q

Form of osteosarcoma that originates from the periosteum of bone and grows outside the bone

A

Parosteal sarcoma

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21
Q

Form of osteosarcoma that often wraps around the diaphysis without breaking through the cortex at all

A

Parosteal osteosarcoma

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22
Q

Treatment of parosteal osteosarcoma

A

Shaving the tumor off the bone or wide bloc excision

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23
Q

Parosteal osteosarcoma are more common in the young or older

A

Older age group

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24
Q

Characteristic of parosteal osteosarcoma that if present, will be considered as aggressive as the central osteosarcoma

A

If it violates the cortex of adjacent bone

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25
Q

Treatment of central osteosarcoma

A

Radical excision

26
Q

Common location from which parosteal osteosarcoma arise

A

Posterior femur, near the knee

27
Q

An avulsion injury that is totally benign but can appear somewhat aggressive and can mimic an early parosteal osteosarcoma

A

Cortical desmoid

28
Q

Myositis ossificans may be confused with what malignant tumor

A

Parosteal osteosarcoma

29
Q

Permeative lesion in the diaphysis of a long bone in a child

A

Ewing sarcoma

30
Q

Area of predilection of Ewing sarcoma

A

40% in diaphysis, the remainder being metaphyseal, diametaphyseal and in flat bones

31
Q

What benign lesion is usually incomparable in terms of appearance with chondrosarcoma

A

Enchondroma

32
Q

Chondrosarcoma may be considered, if a lesion that looks like enchondroma has what other clinical features

A

Painful, shows periostitis and cortical destruction

33
Q

If a soft tissue mass or edema is present in an enchondroma-like lesion, what should be considered, enchondroma or chondrosarcoma?

A

Chondrosarcoma

34
Q

Appearance of chondrosarcoma in radiographs

A

Snowflake or popcorn like amorphous calcification

35
Q

About how many percent of gcts are malignant

A

15%

36
Q

Lytic malignant tumors that do not produce osteoid or chondroid matrix

A

Malignant fibrous histiocytoma or fibrosarcoma

37
Q

One of the few malignant tumors that can, on occassion have a bony sequestrum

A

MFH

38
Q

A half-grade MFH

A

Desmoid tumor, aka desmoplastjc fibroma or aggressive fibromatosis

39
Q

These lesions commonly arise in the soft tissue, when in bone, they are lytic but are usually fairly well defined because of their slow growth. Often have benign periostitis present that has thick spicules or spikes, have multilocular appearance with thick bony septa. Do not metastasize by can exhibit inexorable tumor extension into surrounding soft tissues

A

Desmoid tumor

40
Q

Neoplasm that has the same appearance as Ewing sarcoma, except that it occurs in older age group

A

Primary lymphoma of bone or reticulum cell sarcoma

41
Q

Only malignant tumor that can involve a large amount of bone while being asymptomatic

A

Primary lymphoma

42
Q

Multiple sclerotic foci in a man are most likely from

A

Prostatic metastases

43
Q

In a woman with sclerotic foci, it is most likely from

A

Breast metastases

44
Q

Only primary tumor that never presents with blastic metastatic disease is

A

Renal cell carcinoma

45
Q

Classic differential diagnosis for expansile, lytic metastasis is

A

Renal cell or thyroid carcinoma

46
Q

Myeloma frequently involves the

A

Calvarium

47
Q

One of the malignant bone lesions that is not characteristically hot on radionuclide bone scan, therefore radiologic bone surveys are performed instead

A

Myeloma

48
Q

Pathognomonic feature of synovial osteochondromatosis

A

Presence of calcific loose bodies

49
Q

Non ossified loose bodies in synovial osteochondromatosis is undistinguishable in what other condition

A

Pigmented villonodular synovitis

50
Q

Typical appearance of pigmented villonodular synovitis in MRI

A

Low signal intensity of synovium on both T1 and T2 that is typical for hemosiderim deposits

51
Q

Tumors now labelled as pleomorphic undifferentiated sarcomas

A

MFH and liposarcoma

52
Q

Cortical holes occur almost exclusively in

A

Radiation and soft tissue hemangioma

53
Q

Commonly associated finding of hemangioma

A

Presence of phleboliths

54
Q

Synovial sarcomas are often seen where

A

Adjacent to joints, very rarely in a joint

55
Q

Tumors that are typically homogeneously bright on T2 to that extent that they can be mistaken for a fluid collection

A

Synovial sarcomas and neural tumors

56
Q

Benign joint lesion that occurs from metaplasia of synovium and leads to multiple calcific loose bodies in a joint

A

Synovial osteochondromatosis

57
Q

Benign synovial soft tissue process that causes joint swelling and pain and occassionally, periarticular erosions. It virtually never has calcifications

A

Pigmented villonodular synovitis

58
Q

Condition that may mimic PVNS in which there is chronic bleeding in joint

A

Hemosiderotic arthritis

59
Q

True permeative pattern of round cell lesions occur in what part of bone

A

Intramedullary or endosteal part

60
Q

Pseudopermeative pattern of bone lesion is seen in what part of bone

A

Cortical

61
Q

Can present as soft tissue mass, appears homogeneously bright on T2 and often septated, seen around the joint of knee

A

Atypical synovial cysts such as Baker cysts

Musculoskeletal Radiology (12 decks)

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