MSK path XI Flashcards
ganglions synovial cysts and osteochondral loose bodies form from what
trauma or degenerative processes
what is a ganglion
1-1.5 cm cyst usually near joint capsule or tendon sheath
usually around wrist
what causes ganglion cyst
cystic or myxoid degeneration of CT
lacks cell lining
do ganglion cysts communicate with joint space
no
what can cause synovial cyst
herniation of synovium though joint capsule or massive enlargement of bursa
what is a baker cyst
synovial cyst in popliteal space in RA
synovial lining in synovial vyst
hyperplastic and contain inflammatory cells and fibrin
what do ganglion and synovial cysts feel like
soft squishy
what is a tenosynovial giant cell tumor
closely related benign neoplasms that develop in synovial lining of joints, tendon sheaths and bursae
clinical variants tenosynovial giant cell tumors
diffuse type- pigmented villonodular synovitis)
localized type- giant cell tumor of tendon sheath
diffuse tenosynovial giant cell tumors form where
large joints
localized type tenosynovial giant cell form where
discrete nodule attached to tendon sheat (commonly the hand)
Dx age for tenosynovial giant cell tumors
20-40s
color diffuse tenosynovial giant cell tumors
red brown, orange yellow
red brown stripes or folds “tiger stripe”
infiltrate subsynovial tissue
localized type tenosynovial giant cell shape
well circumscribed
diffuse type tenosynovial giant cell type presents where
knee then hip, ankle, and calcaneocuboid joints
Sx diffuse type tenosynovial giant cell
pain, locking and recurrent swelling similar to monoarticular arthritis
what limits ROM in joint in tenosynovial giant cell tumors
tumor progression
characteristics of localized type tenosynovial giant cell tumor
solitary, slow growing, painless
usually tendon sheaths on wrists and fingers
most common mesenchymal neoplasm of hand
localized type tenosynovial giant cell
tenosynovial giant cell tumors are Tx how
surgical excision
what drugs are used in tenosynovial giant cell tumors
M CSF antagonists b/c block proliferation of giant cells
what is soft tissue
non epithelial excluding skeleton, joints, CNS, hematopoietic and lymphoid tissues
what are more common benign or malignant soft tissue neoplasms
benign all the way
most soft tissue tumors arise where
thigh
what is big determinant for soft tissue tumor benign vs malignant
above or below fascial plane
what translocation for ewing sarcoma
t11;22
soft tissue tumor with eosinphilic spindle cells at 90 angles
smooth muscle type
soft tissue tumor with short fascicles of spindle cells like spokes on a wheel
fibrohistiocytic
soft tissue tumor arranged in columns, palisading
schwann cell
what is characteristic of schwannoma
antoni A and B
soft tissue tumor with herringbone
fibrosarcoma
soft tissue tumor with mixture fascicles of spindle cells and groups epithelioid cells biphasic
synovial sarcoma
important prognostic factors in soft tissue tumors
muscle differentiation, degree of differentiation, size and depth
what looks like chinese characters on histo
fibrodysplasia
what is a benign tumor of fat and most common soft tissue tumor of adulthood
lipoma
what are liposarcomas
50s-60s in deep soft tissues in proximal extremities and retroperitoneum
subtypes liposarcomas
well differentiated
myxoid (basophilic extracellular matrix and capillaries, fetal fat looking like stuff)
pleomorphic- sheets anaplastic cells, bizarre nuclei and lots of immature adipocytes
what color is the myxoid type liposarcoma
gray
what is nodular fascitis
self limited fibroblastic and myofibroblastic proliferation that typically occurs in young adults of upper extremity
what is always present in Hx for nodular fascitis
history of trauma
5 cm lesion circumscribed, rich cellularity with immature fibroblasts and myofibroblasts in short fascicles
cells vary in shape with conspicuous nucleoli
lots of mitoses
lymphocytes and RBC common
nodular fascitis
dupetryns contraction is an example of what
fibromatoses
what is pink stuff in fibromatoses
fibrocollagen
superficial fibromatosis
infiltrative fibroblastic proliferation
broad fascicles of fibroblasts in long sweeping fascilces with dense collagen
what is most comon types of fibromatoses superficial
palmar and plantar
what is peyronie disease
penile superficial fibromatoses
what are desmoid tumors
deep fibromatosis
recur but no metastasis
when do deep fibromatosis present
teens-30s and F>M (weird)
types of deep seated fibromatosis
extraabdominal, abdominal and intraabdominal
when do you see the extraabdominal deep fibromatosis
W with many babies and C csection scarring
gray white firm poorly demarcated mass 1-15 cm
rubbery tough with infiltraiton of muscle nerve and fat
bland fibroblasts in borad sweeping fascicles
fibromatoses
