Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Radiology Tumors > Malignant tumors > Flashcards

Malignant tumors Flashcards

1
Q

what is another name for multiple myeloma

A

kahlers disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the age range of multiple myeloma

A

50-70 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

where does multiple myeloma occur

A

diaphysis of long tubular bones

spine and skull

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what are some characteristic features of multiple myeloma

what is the hallmark feature

how is this different from mets

A

punched out lesions** - HALLMARK

earliest - osteoporosis

moth eaten bone 
rain drop skull 
pancake vertebrae - or vertebrae plana 
unexplained osteoporosis compression fractures 
spared pedicles

uniform size lesions in MM
non uniform size in mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what are the symptoms of multiple myeloma

what is the cardinal sign

A

pain is cardinal sign

pain with increased activity (old man with back pain after shoveling snow)

anemia, weight loss, cachexia, renal disease

pain worse with activity or throughout the day - back pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

is multiple myeloma visible on bone scan

A

no !

no osteoblast activity

may be present if pathological fracture is present with MM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the most common malignant tumor

A

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what do you see on lab work with multiple myeloma

A

m spike on serum elctrophoresis - 90%

IgG myeloma - 50%

bence jones protein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is best imaging for multiple myeloma

what is seen on MR

A

MRI is best - shows marrow infiltration

low signal t1

high signal t2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

half of the people that get solitary plamocytoma are under the age of

A

50 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is a solitary plamocytoma look like

A

single multiple myeloma lesion

expansile and soap bubble like

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what does solitary plamocytoma lead to

what percent of cases does that occur

A

70% develop multiple myeloma in 5 years time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what do multiple myeloma lesions look like

A

circumscribed osteolytic lesions - uniform in size and shape

osteoporosis

wrinkled vertebrae

pedicle sign- spared pedicles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

in what occupations does mutiple myeloma occur in

A

agriculture - pesticides such as DDT

exposure to wood dust
sheet metal
nuclear industry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the most common malignant tumor

A

multiple myeloma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

where do solitary plasmacytoma occur

A

Mc in mandible, ilium, vertebrae, ribs, proximal femur, scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what is a central osteosarcoma

what are the different types of central osteosarcoma

what is most common

A

undifferentiated connective tissue and forms of neoplastic osteoid

sclerotic - 50%
lytic - 25%
mixed - 25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what do the different types of central osteosarcoma look like

A

lytic - focal metaphyseal lesion, permeative, mottled, wide or poor zone of transition

sclerotic - dense ivory or sclerotic medullary lesion, cumulus cloud appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

where are central osteosarcomas typically located

A

metaphysis

MC in distal femur

distal femur and proximal tibia - MC around knee

and humerus / shoulder

vertebral body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what tumor is known to stop expanding once it reaches the physis or growth plate so it never enters the epiphysis

A

central osteosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are general features of central osteosarcoma

A 
metaphysis 
stops at physis
wide zone of transition 
codmans triangle 
spiculated or sunburst periosteal reaction 
soft tissue mass  
cortical disruption 
dense ivory or sclerotic lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what tumor is known to cause cannonball mets and spontaneous pneumothorax

A

central osteosarcoma (>5cm) - mutiple ossified pulmonary lesions - indicates sacromatous pulmonary bone growth

pneumo - subpleural nodules excavate leading to rupture in pleural space

cannonball mets - lungs mets via blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the age range for central osteosarcoma

A

10-25 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is the 2nd most common malignant bone tumor

A

central osteosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the symptoms of central osteosarcoma

A

85% of time - insidious pain and swelling that cannot be relieved - becomes more severe and persistent

weight loss, cachexia, and fever are all unusual*

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how long can it take to diagnose central osteosarcoma

A

6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is increased in the blood when a patient has a central osteosarcoma

A

alk phos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

if a patient has pagets disease, what will be increased in malignant transformation

A

alk phos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what does central osteosarcoma look like on bone scan

A

hot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what does central osteosarcoma look like on MRI and CT

A

will notice soft tissue mass and marrow infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what is the treatment for central osteosarcoma

A

excision, amputation, chemo, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what is the most fatal type of central osteosarcoma

A

lytic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

parosteal osteosarcoma occurs at what age

A

30-50 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

parosteal osteosarcoma occurs where in the body

A

on bone surface, juxta cortical

MC on posterior distal femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

is there a periosteal reaction with parosteal osteosarcoma

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

what is the appearance of a parosteal osteosarcoma

A

slow growing

lobulated, sessile attachment to bone with broad attachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what do you look for on CT and MRI when looking at a parosteal osteosarcoma

A

CT - cleavage plane (1-3 mm)

CT or MRI - medullary extension

CT helpful if invades bone - poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

what are the symptoms of parosteal osteosarcoma

A

swelling, dull aching pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what is the ddx for parosteal osteosarcoma

what imaging do you use to clarify

A

myositis ossificans - if no trauma its probably parosteal osteosarcoma

myositis ossificans is denser around the periphery and shrinks over time

CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

what is the treatment for parosteal osteosarcoma

A

excision, chemo, radiation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

what does multicentric osteosarcoma look like

and where does it occur

A

looks like multiple independent central osteosarcomas that occur simultaneously

metaphysis

BL symmetrical blastic lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

at what age does mlticentric osteosarcoma occur at

A

5-10 years old

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

what is prognosis for multicentric osteosarcoma

A

rapidly fatal most often

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

what is elevated in the blood with multicentric osteosarcoma

A

alk phos

lesions are blastic so alk phos increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

where does multicentric osteosarcoma metastasize to

A

lungs - occurs early on in disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

how does a person get secondary osteosarcoma

A

transformation of other conditions into osteosarcoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

what are some examples that can cause secondary osteosarcoma

A

BRCA
wilms tumor
radium poisoning - dial painters on watches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

how long does it usually take for secondary osteosarcoma to occur

A

latent period of 5-40 years
(sometimes post radiation)

15 years most common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

where is extraosseous osteosarcoma found

A

not in bone
in soft tissues

MC in the thigh

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

what does extraosseous osteosarcoma look like

A

large soft tissue mass adjacent to bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

what is the common age group for extraosseous osteosarcoma

A

30-50 years old

52
Q

high incidence of secondary osteosarcoma occurs in what

A

pagets disease
and
post radiation patients

53
Q

where do chondrosarcomas occur

A

metaphysis

MC in pelvis
proximal femur, and flat bones

54
Q

what do chondrosarcomas look like

A

large radiolucent lesions with central rings of calcification

expansion of bone

flocculent calcification, cotton wool, or popcorn appearance

laminated and spiculated periosteal reaction

55
Q

what is the age range for chondrosarcoma

A

40-60 years old

56
Q

what is the 3rd most common primary malignant bone tumor

A

chondrosarcoma

57
Q

what are symptoms of chondrosarcoma

A

pain and soft tissue swelling

58
Q

how do chondrosarcomas spread

A

spread only by direct extension - not blood

59
Q

which primary malignant tumor has the best prognosis

A

chondrosarcoma

60
Q

what is the treatment for chondrosarcoma

A

surgery only

chemo and radiation does not work

61
Q

what does chondrosarcoma look like on bone scan

what about MRI

A

hot

low on t1
high on t2

62
Q

where does ewings sarcoma occur

A

diaphysis of metadiaphysis

long tubular bones and pelvis

MC in femur

63
Q

what does ewings sarcoma look like

A

cortical saucerization

permeative lesion with long zone of transition

laminated or onion skin periosteal reaction

codmans triangles

erlenmeyer flask deformity

lytic and sclerotic

extremely undifferentiated and malignant

64
Q

what age does ewings sarcoma occur at

A

10-25 years old

peak at age 15

65
Q

what are symptoms of ewings sarcoma

A

localized pain and swelling
palpable soft tissue mass
fever and anemia

66
Q

what is the most common primary malignant to metastasize

where does it metastasize

A

ewings sarcoma

to the lung

67
Q

ewings sarcoma appears like what because of the blood panel

whats elevated

A

looks like infection

increase ESR, WBC

fever and anemia also present

68
Q

what is treatment for ewings sarcoma

A

amputation, chemo, radiation

69
Q

what malignant tumor mimics an infection because of increased ESR and WBC

A

ewings sarcoma

70
Q

where do fibrosarcomas occur

young and older

A

metaphysis

MC in femur, tibia (50%), humerus

young - tubular bones - knee

older - flat bones - pelvis

71
Q

what do fibrosarcoma lesions look like

A

eccentric, purely lytic, radiolucent, moth eaten, permeative (destructive)

no calcification and no periosteal reaction and no codmans triangles

extremely large soft tissue masses

expansile lesions with cortex disruption*

wide zone of transition

endosteal scalloping

72
Q

what age group do fibrosarcomas occur in

A

30-50 years old

73
Q

fibrosarcomas can transform into what

how do you treat this transformation

A

malignant fibrous histicytoma
(undifferentiated pleomorphic osteosarcoma)

highly malignant and destructive so amputate now!

74
Q

fibrosarcomas occur secondary to what

A

pagets
radiation
osteomyelitis

75
Q

what does a fibrosarcoma produce

A

varying amounts of collagen

76
Q

1/3 of patients with fibrosarcoma present with what

A

pathological fracture

77
Q

where does a fibrosarcoma metastasize to if amputation is not performed

A

lung and liver

78
Q

what is a rare primary malignant bone tumor arising from vestigial remnants of the notochord

A

chordoma

79
Q

what age group do chordomas occur in

A

40-70 years old

80
Q

what are the 3 different types of chordomas

A

sacrococcygeal chodroma - 50%
spheno-occipital chordoma - 35%
vertebral chordoma - 15%

81
Q

how do chordomas spread

A

cross the vertebral disc/joint spaces and spread to adjacent vertebral body segments

82
Q

what are symptoms of chordomas

A

sacrococcygeal - presacral tumor (found on rectal exam ), pressure of tumor causes constipation and GI issues, cauda equina symptoms

spheno-occpital chordoma - seen at region of clivus, increased intracranial pressure, headaches, blurred vision, diplopia, nasal obstruction, cerebellar involvement

vertebral - pressure on nerve roots or cord, dysphagia, difficulty breathing, pain, numbness, motor weakness

83
Q

what is the most common location for a vertebral chordoma

where is it not found

A

MC - C2

not found in posterior elements

84
Q

what is treatment of chordoma

A

resection of tumor is best

radiation therapy

85
Q

what is another name for non hodgkins lymphoma

A

reticulum cell sarcoma
or
lymphosarcoma

86
Q

non hodgkins occurs where

A

diametaphyseal
metaphysis

knee, femur, tibia, humerus

87
Q

what does a non hodgkins lymphoma lesion look like

A

begins in medullary cavity and expands towards cortex

localized lytic moth eaten lesions

laminated periosteal reaction - not always present

soft tissue mass - later stages

may have compression fractures of the spine

88
Q

what are the symptoms of non hodgkins lymphoma

A

patient feels good overall, even with large lesions

pathological fracture may be first complaint because patient feels food overall before

intermittent pain

dull aching pain - not relieved by rest

89
Q

in what age range do you seen non hodgkins lymphoma

A

20-40 and 40-50 years old

90
Q

what is the treatment for non hodgkins lymphoma

A

radiation and chemotherapy

decent prognosis

91
Q

what are the most common lesions seen in hodgkins lymphoma

what lesions involved in hodgkins lymphoma are more symptomatic

A

osteolytic 75%
osteoblastic 15%
mixed 10%

lytic > blastic

92
Q

hodgkins lymphoma can cause what that leads to spinal cord compression

A

compression fractures and vertebral collapse

93
Q

what is the primary site of skeletal involvement seen in hodgkins lymphoma

where specifically

A

vertebral body

lower thoracic
upper lumbar
aka TL junction

94
Q

what do the lesions involved in hodgkins lymphoma look like

A

ivory vertebrae

lytic lesions, moth eaten
(maybe periosteal reaction)

anterior vertebral scalloping

95
Q

what disease causes mediastinal widening on CXR

what causes the mediastinal widening

A

non hodgkins lymphoma

lymphadenopathy

96
Q

non hodgkins lymphoma appears as what on bone scan

A

hot

97
Q

what does hodgkins lymphoma appear as on MRI

A

low on t1
high on t2
enhances with GAD

98
Q

what is treatment for hodgkins lymphoma

A

radiation and chemo

99
Q

what does the diagnosis of primary bone lymphoma include

A

involvement of singe bone with no evidence of disease elsewhere for at least 6 months after diagnosis

100
Q

in primary lymphoma of bone, signs of systemic disease such as fever, weight loss, and night sweats are __

neuro symptoms are __

A

absent

maybe present depending on if compression fracture is involved

101
Q

where are giant cell tumors typically located

what location is there most malignant cases

what is most common spinal site

A

metaphysis - spreads to epiphysis/subarticular region

distal femur, proximal tibia, humerus, radius, sacrum

most malignant - radius

mc spinal - sarcum

102
Q

what do giant cell tumors look like

A

purely lytic lesions with central septations

soap bubble appearance

thinned expanded cortex

cortical breakthrough and soft tissue mass

103
Q

what is the age range for giant cell tumor

A

20-40 years old

104
Q

what are the symptoms of giant cell tumor

A

intermittent pain, aching, localized, swelling, and tenderness

105
Q

giant cell tumors originate in the __ of the bone and extend to the __ of the bone

A

metaphysis

subarticular region

106
Q

what is a quasimalignant tumor of bone

A

giant cell tumor

107
Q

what 3 things do you have to do to diagnose a giant cell tumor

A

radiologic
clinical
histological

108
Q

what is treatment for giant cell tumor

A

removal of tumor

or radiation if it is inoperable

109
Q

straining may produce pathological compression fracture in multiple myeloma that may result in what

A

paraplegia

110
Q

low back pain associated with multiple myeloma may be misdiagnosed as what

A

disc or sciatic nerve problems

111
Q

what are the 3 round cell tumors or disorders

A

multiple myeloma
ewings sarcoma
non hodgkins lymphoma

112
Q

mutiple myeloma has increased osteoblast or clast activity

A

osteoclast

113
Q

people with multiple myeloma usually die of what

A

pneumonia
respiratory failure
renal failure

114
Q

where are extraosseous plasmacytomas seen

A

MC in nasopharynx, nasal cavity, oral cavity, tonsils, larynx, sinuses

115
Q

MM

plasma cells release ___, therefore __ are deficient in patients and thus a negative bone scan

A

osteoclastic activating factors

osteoblasts

116
Q

why is MM often missed on diagnosis

A

may think its mechanical pain

patient presents with initial finding of osteoporosis and back pain

117
Q

what is prognosis for MM

A

BAD

90% die within 3 years

118
Q

what tumor is seen in affected patients that appear taller than other in the same age group

A

central osteosarcoma

119
Q

what acts as a barrier for central osteosarcoma so it doesnt spread

A

physis

120
Q

pathological fractures associated with multiple myeloma occur how so

A

transversely oriented

121
Q

patients with multiple myeloma usually die from what

A

pneumonia, respiratory failure, or renal failure

122
Q

what leads to renal failure in multiple myeloma

A

bence jones proteins - renal casts with inflammatory infilitrate

123
Q

what if there are more non uniform size lesions in mutliple myeloma

A

metastasis disease

124
Q

why should you be concerned for the future of a patient with a solitary plasmacytoma

A

70% leads to MM and die in 5 years

MM has occurred 23 years later - long term follow up is important

125
Q

what is considered in multiple myeloma patients that show more than 50% loss of shaft diameter on xray

A

prophylatic intramedullary nailing

126
Q

what is a rare form of multiple myeloma

what does it mean

what is typically seen on xray

A

POEMS

polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes

sclerotic lesions on xray

127
Q

radiographs of treated myeloma patients may show areas of abnormal bone architecture with __

A

sclerosis

Radiology Tumors (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions