MSK Tumors - Diagnosis

Question 1

Pathological characteristics of Adamantinoma

Answer 1

Epithelial islands
Columnar cells in palisaded pattern
Resemble cutaneous basal cells
Dispersed in fibrous stroma

Question 2

What tumors appear in midshaft Tibia

Answer 2

Adamantinoma (rare-primary malignant bone tumor)

Osteofibous Dysplasia

Question 3

Pathological features of Osteofibrous Dysplasia

Answer 3

Woven bone deposition, Osteoblastic riming

Cells are longitudinal to stellate shaped

Question 4

Benign Bone lessons ages 40-80

Answer 4

BE HIP
Bone Island
Enchondroma
Hyperparathyroidism
Infarcts
Padgets

Question 5

Malignant Bone lessons ages 40-80

Answer 5

Metastatic bone disease
Multiple Mylemoma
Lymphoma

Chondrosarcoma
Malignant fibrous histocytoma
secondary sarcomas

Question 6

Most common cause of bone Metastases to hand?

Answer 6

Lung Ca

Question 7

Immuno stain CD20

Answer 7

Lymphoma B cells

Question 8

Immuno stain CD99(013)

Answer 8

Ewings

Question 9

Immuno stain Kerratin, S100

Answer 9

chordoma

Question 10

Immuno stain Keratin

Answer 10

Adamantoma or Metastatic cancer

Question 11

Immuno stain CD138

Answer 11

Myeloma

Question 12

Immuno stain S-100, CD1A

Answer 12

Langerhans cell histocytosis (EOG)

Question 13

what are Bence Jones proteins

Answer 13

Myeloma - light chains(kappaor lamda) released into the urine

Question 14

Why is myeloma lytic?

Answer 14

plasma cells secrete osteoclast activating factor - IL-6, Macrophage Inflammatory factor 1 alpha MIP-1A
osteoclasts recruited and resorb trabecular and cortical bone

Question 15

Systemic Complications of myeloma?

Answer 15

Nephropathy, Hypercalcemia, Anemia

Question 16

Histology of Myeloma

Answer 16

Clock faced nucleus
peri-nuclear clearing
eccentric nucleus
dense and eosinophilic cytoplasm