Neoplastic pathology Flashcards
What genetic techniques can be employed on fresh tissue?
Karyotyping
FISH
How is karyotyping carried out?
Culture cells and then arrest during cell division
Useful for an over-view of chrosomal structure but will not detect smal lesions
What is FISH useful for?
For known translocations
Can paint the relevant small area of chromosomes
Performed on fixed tissue
What is immunohistochemistry used for?
To determine if a protein is present - place a pigment on an antibody to the target protein and any pigment staning left means the protein is present
What are some common benign lesions?
Ganglion cyst
Giant cell tumour
Fibromatosis
What are some rare benign lesions?
Fibrous cortical defect
Fibrous dysplasia
What is a ganglion cyst?
Peripheral lump near a joint capsule or tendon sheath - common around wrist
Not a true cyst - no epithelial linning
What does a ganglion cyst look like histologically?
Space with myxoid material. Secondary inflammatory changes
What are some examples of superfiical fibromatosises?
Duptryen’s contracture
Knuckle pads
Plantar
Penile - peryonie’s
What are some examples of deep fibromatoses?
Mesenteric or pelvic
Desmoid tumours
Associcated with FAP
What are giant cell tumours?
Pigmented villonodular synovitis (PVNS) - large joints
Giant celll tumour of tendon sheath (GCTS) - digits
What is the difference between GCTS and PVNS
GCTS is small nodules that are easily excised
PVNS are more destructive and diffuse in a joint space
Where do angiolipomas commonly occur?
Multiple and peripheral
Vascular with fibrin thrombi
What are the lesions that cause pain?
ANGEL: Angiolipoma Neuroma (traumatic) Glomous tumour (nail beds) Eccrine spiradenoma Leiomyoma (cutaneous)
What molecular test can be done to detect a leiomyoma or leiomyosarcoma?
IHC to detect actin, desmin or caldesmon
What is the malignant tumour of skeletal muscle called?
Rhabdomyosarcoma
Who is likely to get a cardiac rhabdomyoma?
Paedeatric
What are the different types of rhabdomyosarcoma?
Embryonal
Alveolar
Pleomorphic
What are the common tumours of cartilage?
Enchondroma
Chondromyxoid fibroma
Where is enchondroma commonly found?
Digits
Can be part of ollier’s or maffuci syndrome
Who is the sarcoma of cartilage likely to affect?
40s/50s
Affects axial skeleton and H&N
What are the different types of benign bone tumours?
Osteoma
Gardner’s syndrome
Osteoid osteoma
Osteoblastoma
What is the most common malignant bone tumour?
Osteosarcoma - paeds, affects knees and commonly spreads to lungs
How can an osteosarcoma be diagnosed radiologically?
Codman’s triangle - the triangular area of new subperiosteal bone that is created when a lesion, often a tumour, raises the periosteum away from the bone
What are the different types of malignant bone tumours?
Osteosarcoma
Ewing’s sarcoma
Synovial sarcoma
Who does ewing’s sarcoma affect?
Children and adolescents
Where will ewings sarcoma present?
Any soft tissue or bony location but commonly long bones
Destructive, rapipdly growing and highly malignant
What type of cell does ewing’s sarcoma originate from?
Primitive mesenchymal or neuroectdermal cell
What genetic abnormalities are associted with ewing’s sarcoma?
t(11;22)
What is a pseudosarcoma?
Tissues undergoing repiar often appear very atypical and the diagnosis can be very difficult
What is nodular fascitis?
Any age group, rapid growth
History of preceeding trauma
What does nodular fasciitis look like histologically?
Very chaotic appearance Haemorrhage Pseudocystic spaces Large, atypical cells Frequent mitoses
What is myositis ossificans?
Affects big muscles - quadriceps, gluteus
What autoantibodies with scleroderma show?
Diffuse anti-scl-70
Anti-centromere
What autoantibodies witll sjogrens show?
Anti Ro La
What will dermatomyositis show?
Anti Jo
What will amyloidosis look like histologically?
Apple green birefringence with congo red staining
What antibodies will RA produce?
Rheumatoid factor
IgM
What will occur to the joint space in RA?
Cartilage is destroyed
Pannus formation - inflammatory cells, hyperplastic synovium
IgM mediated so many IgM cells
