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Pathology > MSK neoplasms > Flashcards

MSK neoplasms Flashcards

1
Q

neoplasms that usually localizes in the facial bones and nasal sinuses

A

Osteoma

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2
Q

complications of an osteoma

A

sinus obstruction

congestion

pressure headaches

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3
Q

Difference between osteoid osteoma and osteoblastoma

A

osteoid osteoma

  • < 2cm
  • diaphysis of long bones
  • Appendicular skeleton

Osteoblastoma

  • >2cm
  • axial skeleton
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4
Q

Describe the morphology of an osteoid osteoma

A

well-circumscribed round/ oval mass in the cortex of long bones

hemorrhagic, tan/ gritty tissue with haphazard interconnections of woven trabeculae rimmed by osteoblasts

Intertrabecular spaces are filled by vascularized loose connective tissue

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5
Q

Clinical presentation of osteoid osteoma

A

severe nocturnal pain that is relieved with ASA

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6
Q

Osteoblastoma clinical presentation

A

dull pain that is unresponsive to ASA

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7
Q

Most common primary malignant tumor of the bone

A

Osteosarcoma

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8
Q

Associations of Osteosarcoma

A

RB

TP53

INK4a

MDM2

CDK4

Paget Disease

Bone Infarcts

Prior radiation

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9
Q

Diagnostics of osteosarcoma

A

appears at the metaphyseal region of long bones

tumor frequently breaks through the cortex and lifts the periosteum, forming a sunburst appearance and Codman’s triangle

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10
Q

Morphology of osteosarcoma

A

gritty, grey-white areas of hemorrhage and or cystic degeneration

fine lacelike pattern of neoplastic bone replaced by anaplastic malignant tumor cells

broad sheets or primitive trabeculae

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11
Q

Clinical presentation of osteosarcoma

A

painfully aggressive enlarging masses in long bones

usually around the knee

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12
Q

2nd most common group of bone sarcomas in children

A

Ewing Sarcoma

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13
Q

Pathology of Ewing Sarcoma

A

t(11q24; 22q12) causes the fusion of EWS gene on chromosome 22 to the FLI1 gene

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14
Q

Diagnostics of Ewing sarcoma

A

appears at the diaphysis of femur, tibia and flat bones of the pelvis

Destructive lytic tumor with permeative margins that extend into the surrounding soft tissues

Periosteal reaction- layers of reactive bone

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15
Q

Morphology of Ewing Sarcoma

A

soft, tan/white areas of hemorrhage and necrosis

sheets of small uniform, round cells with scant cytoplasm

cytoplasm appears clear due to abundance of glycogen

Homer wright rosettes

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16
Q

Ewing Sarcoma Clinical Presentation

A

painful enlarging mass with tenderness warmth and swelling

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17
Q

Multiple Enchondromas

Ollier Disease

Maffucci Syndrome

A

Associations of Chondromas

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18
Q

Diagnostics of Chondromas

A

found in the metaphysis of tubular bones in hands and feet

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19
Q

Morphology of chondromas

A

well-circumscribed nodules of hyaline cartilage containing cytomorphological benign chondrocytes

sclerotic rim with an intact cortex

usually < 3cm

Grey-blue and translucent

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20
Q

Late adolescence- early adulthood

multiple hereditary exostosis syndrome

chondrosarcoma

A

Osteochondroma associations

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21
Q

Most common primary benign bone tumor

A

Osteochondroma

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22
Q

Pathology of Osteochondromas

A

inactivation of the EXT gene

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23
Q

Diagnostics of Osteochondromas

A

appears at the metaphysis of the bone near the knee

benign cartilage capped tumor that is attached to the underlying skeleton by a bony stalk

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24
Q

Morphology of Osteochondromas

A

Cap is composed of benign hyaline cartilage varying in thickness and has the appearance of a disorganized growth plate

Pedunculated lesion with a bone stalk that is continuous with the cortex and medullary cavity of the underlying bone

underlying stalk contains cancellous

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25
Q

Osteochondroma clinical presentation

A

painful and tender near the ends of long bones

26
Q

2nd most common malignant matrix producing tumor of bone

A

Chondrosarcoma

27
Q

Predisposing factor of chondrosarcoma

A

Osteochondroma

28
Q

Diagnostics of Chondrosarcoma

A

Large bulky tumors of the Axial skeleton

nodules of glistening gray-white translucent cartilage

29
Q

Chondrosarcoma morphology

A

matrix is often gelatinous or myxoid

cartilage infiltrates marrow space and surrounds pre-existing bone trabeculae

Nuclei often show up and open chromatin pattern with atypia

30
Q

Clinical presentation of chondrosarcoma

A

painful progressive enlarging masses in the pelvis and axial skeleton

usually metastasize to lungs

31
Q

Most common soft tissue tumor of adulthood

A

Lipoma

32
Q

Features of lipomas

A

well-encapsulated mass of mature adipocytes

usually soft, mobile and painless

arises in SubQ of proximal extremities and trunk

33
Q

Pathology of Liposarcoma

A

t(12;16) causes amplification of 12q13-15

causes mutation in MDM2, disinhibiting p53

34
Q

Pathology of Nodular Fasciitis

A

t(17;22) produces a MYH9-UPS6 fusion gene

35
Q

Diagnostics of Nodular Fasciitis

A

usually arises in the deep dermis, SubQ or muscle

36
Q

Morphology of Nodular Fasciitis

A

usually < 5cm

circumscribed or slightly infiltrative

Richly cellular in immature appearing fibroblasts, myofibroblasts, lymphocytes and extravasated RBCs

Cells vary in shape and size

Cells have conspicuous nucleoli

Gradient of maturation from cellular, loose and myxoid to organized fibers

37
Q

Which fibromatosis?

Males> females

Dupuytren contracture

Peyronie disease

A

superficial fibromatosis

38
Q

Which fibromatosis?

women> men

Gardner Syndrome

FAP and APC mutations

arise in musculoskeletal aponeurotic structures, limb girdles or mesentery

A

Deep Fibromatosis

“Desmoid Tumor”

due to mutations in APC or Beta Catenin causing increased Wnt signaling

39
Q

Morphology of fibromatoses

A

firm, grey-white lesions

poorly demarcated masses 1-15cm

Tough and rubbery, marked with infiltration of surrounding muscle, nerve and fat

cytologically bland fibroblasts are arranged in broad sweeping fascicles amid dese collagen

resembles a scar

40
Q

osteoclastoma

A

tensynovial giant cell tumor

41
Q

Pathology of tensynovial giant cell tumors

A

neoplastic mononuclear cells produce RANKL to induce osteoclast formation

42
Q

Diagnostics of osteoclastoma

A

soap bubble lytic lesion surrounded by a thin bony shell, usually around the knee

Adults: usually appears at epiphysis or metaphysis

Children: usually appears at the metaphysis

XR: multicystic osteolytic lesions

43
Q

Morphology of Tensynovial Gian Cell Tumor

A

red-brown mass with cystic degeneration

composed of reactive giant cells and neoplastic mononuclear cells

44
Q

Clinical presentation of tensynovial giant cell tumors

A

local pain and swelling

pathologic fractures

45
Q

Associations of fibrous dysplasia

A

mutations in GNAS1 gene

Increased cAMP

McCune-Albright Syndrome

Mazabraud Syndrome

46
Q

Morphology of Fibrous dysplasia

A

Gritty, tan-white, well-circumscribed intramedullay mass

Curvilinear trabeculae of woven bone surrounded by a moderately cellular fibroblastic proliferation

No osteoblastic rim

47
Q

Malignant bone tumor in metaphysis of long bones

A

Osteosarcoma

48
Q

Malignant cartilage tumor in metaphysis of Axial Skeleton

A

Chondrosarcoma

49
Q

Malignant cartilage tumor in diaphysis

A

Chondrosarcoma

50
Q

Malignant bone tumor in the diaphysis of femur, tibia or pelvic bones

A

Ewing Sarcoma

51
Q

Benign bone tumor in appendicular skeleton

A

Osteoid Osteoma

or

Fibrous Dysplasia

52
Q

Benign bone tumor of the metaphysis or epiphysis

A

Giant Cell Tumor

53
Q

Benign bone tumor in metaphysis of facial bones

A

osteoma

54
Q

Benign bone tumor in metaphysis of axial skeleton

A

osteoblastoma

55
Q

Benign cartilage tumor in metaphysis near the knee

A

osteochondroma

56
Q

Benign cartilage tumor in the metaphysis of tubular bones

A

Chondroma

57
Q

Benign tumor found in the metaphysis of long bones or posterior vertebral bodies

A

Aneurysmal Bone Cyst

58
Q
A
59
Q
A
60
Q
A

Pathology (18 decks)

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