Multisystem Flashcards
Pathology?
Osteoporosis
increased resorption and decreased bone formation; overall organic to mineral matrix balance remains the same, but spicules are smaller, thinner, and more fragile
Pathology?
Osteomalacia
overabundance of organic matrix that is not mineralized, due to a deficiency of vitamin D; see widening of osteoid seams
Pathology?
Paget’s disease (osteitis deformans)
caused by infection of osteoclasts by Paramyxovirus; osteolytic stage (osteoclast stimulated by virus, resorbs bone) => osteolytic/osteoblastic stage (lysis of bone continues, but also osteoblastic activity laying down abnormal bone) => mosaic pattern
often incidental finding
Pathology?
Osteomyelitis
infection of the bone (60% S. aureus; Beta hemolytic strep next most common)
Radiographic finding?
Buttress
periosteal reaction caused by slow-growing tumors that provoke cortical thickening
Radiographic finding?
Codman’s triangle
elevation of periosteum to a significant degree, forming and acute angle
Radiographic finding?
Hair-on-end appearance
periosteal reaction due to new bone formation
Radiographic finding?
Osteoid
cloud-like or ill-defined amorphous densities with haphazard mineralization
Radiographic finding?
Chondroid
focal stippled or flocculent densities, or in lobulated areas, as rings or arcs of calcifications
Pathology?
Osteoid osteoma
benign, bone-producing neoplasm; small size, limited growth potential, but causes extensive reactive changes in surrounding tissues
10-25 years; 50% in femur and tibia
Pathology?
Osteoid osteoma
thin, often interconnected spicules of osteoid and woven bone rimmed by osteoblasts; osteoclast-like giant cells can be seen; intervening fibrous stroma shows prominent vascularity; without significant nuclear atypia
Pathology?
Osteoblastoma
rare, bone-producing neoplasm
second and third decades; axial skeleton (spine and sacrum), mandible, and other craniofacial bones
Pathology?
Osteoblastoma
resembles osteoid osteoma; osteoblasts and osteoclast-like giant cells rim interconnected spicules of osteoid and woven bone; intervening stroma shows prominent vascularity; no significant atypia
Pathology?
Osteosarcoma
malignant tumor of neoplastic mesenchymal cells synthesizing osteoid or immature bone
second decade; distal femur and proximal tibia, proximal humerus
Pathology?
Osteosarcoma
highly pleomorphic cells and haphazard deposits of osteoid; anaplastic features and mitotic activity; lace-like pattern
Pathology?
Osteosarcoma
highly pleomorphic cells and haphazard deposits of osteoid; anaplastic features and mitotic activity; lace-like pattern
Pathology?
Osteochondroma
cartilage-capped outgrowth attached to underlying bone by a bony stalk
M>F; usually stops growing when skeletal maturity reached
EXT1 and EXT2 gene deletions (q24 of chromosome 8, p11-12 of chromosome 11)
Pathology?
Osteochondroma
uniform, cartilaginous cap with stippled calcifications; cortex and medulla are continuous with those of lesion
Pathology?
Chondroma
common, benign, intramedullary bone tumor composed of mature hyaline cartilage
third and fourth decades; limited growth potential
vague lobularity (soap bubbles)
Pathology?
Chondroma
abundant cartilaginous matrix, can be focally calcified; low cellularity; clustered and scattered chondrocytes with small, uniform, darkly staining nuclei; occasional binucleated chondrocytes
Pathology?
Chondroblastoma
rare, benign neoplasm occurring second decade when growth plates are still open
70% in proximal humerus and knee, invariably at EPIPHYSIS
irregular but circumscribed, radiolucent epiphyseal lesion surrounded by reactive bone sclerosis
Pathology?
Chondroblastoma
highly cellular, sheets of round to polygonal cells; multiple small foci of immature bluish-pink chondroid give a lobular appearance; multinucleated giant cells; chicken-wire (right photo) calcification
Pathology?
Chondromyxoid fibroma
well-defined, expansile lytic lesion, centered at metaphysis and bordered by sclerotic rim
<40 years, peak incidence 10-20 years; 30% in knee area
Pathology?
Chondromyxoid fibroma
moderately cellular chondromyxoid tissue with vague lobularity and mildly pleomorphic, angular and stellate cells set in bluish-pink chondromyxoid stroma
Pathology
Chondrosarcoma
malignant, cartilage-producing tumor
30-50 years, extremely rare in children; bones of trunk (pelvis), femur, and humerus
Pathology?
Chondrosarcoma
large, lobulated, ill-defined lesion; moderately cellular, atypia
Pathology?
Non-ossifying fibroma
common, non-neoplastic, self-healing lesion occurring in skeletally immature individuals 5-20 years
often incidental findings
sharply demarcated, lucent, lobulated, meta-diaphyseal lesion surrounded by sclerotic rim
Pathology?
Non-ossifying fibroma
moderately cellular lesion composed of uniform spindle cells in a storiform pattern and scattered giant cells; mitotic figures easily found; foamy histiocytes (xanthoma cells) and hemosiderin-laden macrophages
Pathology?
Fibrous dysplasia
inability of tissue to produce mature lamellar bone; benign fibro-osseous lesion; 10-25 years; intramedullary location
long bones (ribs, femur, tibia, jaw, humerus) in metaphysis or diaphysis
Pathology?
Fibrous dysplasia
thin wavy spicules of woven bone; lack of osteoblastic rimming or osteoclastic activity
Pathology?
Giant cell tumor
relatively uncommon, locally aggressive neoplasm that may produce bone destruction and soft tissue destruction
20-50 years
65% in distal femur, proximal tibia, and distal radius
well-defined, lytic lesion eccentrically located in epiphysis with subchondral and metaphyseal extension
Pathology?
Giant cell tumor
multinucleated giant cells in a background of small, ovoid, mononuclear stromal cells with poorly defined cytoplasmic borders
Pathology?
Ewing’s sarcoma
arises in medullar cavity, invades cortex and periosteum, and frequently produces soft tissue mass
80% occur between 5-20 years
diaphysis of femur, tibia, humerus, pelvis, and ribs
Pathology?
Ewing’s sarcoma
sheets of primitive cells with little histological evidence of differentiation; mitotic rate is relatively low; positive for CD99/O13
Pathology?
Lipoma
Pathology?
Spindle cell lipoma
Pathology?
Angiolipoma
Pathology?
Intramuscular lipoma
Pathology?
Lipoblastoma
Pathology?
Lipoblastoma
Pathology?
Liposarcoma type 1: well-differentiated liposarcoma
Pathology?
Liposarcoma type 2: myxoid liposarcoma
Pathology?
Liposarcoma type 3: pleomorphic liposarcoma
Pathology?
Nodular fasciitis
Pathology?
Palmar superficial fibromatosis (Dupuytren contracture)
Pathology?
Palmar fibromatosis
dense, but uniform, proliferation of fibroblasts with dense collagen in superficial fibromatosis
Pathology?
Deep fibromatoses (desmoid tumors)
large infiltrative masses in anterior abdominal wall, limb girdles, or mesentery; most common in young F
Pathology?
Myositis ossificans
athletic adolescents and young adults, often following trauma
Pathology?
Rhabdomyosarcoma
most common soft tissue sarcoma of childhood and adolescence
Pathology?
Alveolar rhabdomyosarcoma
Pathology?
Leiomyoma (top), leiomyosarcoma (bottom)
Crystal type?
Urate crystals
Crystal type?
Calcium pryophosphate dihydrate crystals
Pathology?
Lyme
Pathology?
Osteoarthritis
Pathology?
Osteoarthritis
Pathology?
Class IV lupus nephritis - Diffuse proliferative nephritis
most common nephritis in lupus
Pathology?
Lupus
Pathology?
Discoid lupus
Pathology?
Sjogren’s syndrome
Pathology?
Scleroderma
Pathology?
Rheumatoid arthritis
left: synovium in RA
right: lymphoid follicles in RA
Pathology?
Rheumatoid arthritis
left to right: swan neck deformity, rheumatoid nodules, ulnar deviation
Pathology?
Giant cell arteritis
vasculitis of large vessels
Pathology?
Giant cell arteritis
Pathology?
Takayasu arteritis
Pathology?
Kawasaki disease
