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Orthopedics > Orthopedic Pathology: Introduction > Flashcards

Orthopedic Pathology: Introduction Flashcards

1
Q

Order of importance for AJCC staging system

A
  1. stage
  2. metastases
  3. skip lesions
  4. grade
  5. size
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2
Q

Enneking System

A

I - Low grade

II - High grade

III - Any grade with metastases

A - Intracompartmental

B - Extracompartmental

EXAMPLES : IA, IB, IIA, IIB, IIIA, IIIB

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3
Q

Low grade tumors:

BONE

A

* parosteal osteosarcoma

* primary chondrosarcoma

* secondary chondrosarcoma

* hemagioendothelioma

* chordoma

* adamantinoma

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4
Q

High grade tumors:BONE

A

* intramedullary osteosarcoma (classic)

* post-radiation sarcoma

* paget sarcoma

* fibrosarcoma

* malignant fibrous histiocytoma

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5
Q

Low grade tumors:SOFT TISSUE

A

* myxoid liposarcoma

* lipoma-like liposarcoma

* angiomatoid malignant fibrous histiocytoma

* rhabdomyosarcoma

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6
Q

High grade tumors:SOFT TISSUE

A

* malignant fibrous histiocytoma

* pleomorphic liposarcoma

* synovial sarcoma

* alveolar cell sarcoma

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7
Q

Common metastatic bone lesions:BIRTH TO 5 YEARS

A

* Leukemia

* metastatic neuroblastoma

* metastatic rhabdomyosarcoma

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8
Q

Common benign bone lesions:BIRTH TO 5 YEARS

A

* osteomyelitis

* osteofibrous dysplasia

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9
Q

Common metastatic bone lesions:10-25 YEARS

A

* osteosarcoma

* ewing tumor

* leukemia

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10
Q

Common benign bone lesions:10-25 YEARS

A

* eosinophilic granuloma

* osteomyelitis

* enchondroma

* fibrous dysplasia

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11
Q

Common metastatic bone lesions:40-80 years

A

* metastatic bone disease

* myeloma

* malignant fibrous histiocytoma

* paget sarcoma

* post-radiation sarcoma

* lymphoma

* chondrosarcoma

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12
Q

B HEMP

Common benign bone lesions:40-80 years

A

* hyperparathyroidism

* paget disease

* mastocytosis

* enchondroma

* bone infarcts

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13
Q

Most common soft tissue tumor in children?

A

Hemangioma

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14
Q

Most common soft tissue tumor in adults?

A

Lipoma

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15
Q

Most common malignant soft tissue tumor in children?

A

Rhabdomyosarcoma

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16
Q

Most common malignant soft tissue tumor in adults?

A

Malignant fibrous histiocytoma

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17
Q

Most common primary benign bone tumor?

A

Osteochondroma

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18
Q

Most common primary malignant bone tumor?

A

Osteosarcoma

19
Q

Most common secondary benign lesion?

A

Aneurysmal bone cyst

20
Q

Most common secondary malignant lesions?

A

* Malignant fibrous histiocytoma

* Osteosarcoma

* Fibrosarcoma

21
Q

Most common phalangeal tumor?

A

Enchondroma

22
Q

Most common sarcoma of hand/wrist?

A

Epithelioid sarcoma

23
Q

Most common sarcoma of the foot/ankle?

A

Synovial sarcoma

24
Q

Typical neoplasms of whole bone:TIBIA

A

* adamantinoma

* osteofibrous dysplasia

25
Q

Typical neoplasms of whole bone:POSTERIOR CORTEX OF FEMUR

A

* parosteal osteosarcoma

* pariosteal desmoid

26
Q

Typical neoplasms of part bone:EPIPHYSIS

A

* giant cell tumor (starts in the meta and works down to epi)

* chondroblastoma

* aneurysmal bone cysts

* osteomyelitis (TB, fungus)

27
Q

Typical neoplasms of part bone:METAPHYSIS

A

* metaphyseal fibrous defect

* aneurysmal bone cyst

* giant cell tumor (starts in the meta and works down to epi)

* osteosarcoma

28
Q

Typical neoplasms of part bone:DIAPHYSIS

A

* ewing sarcoma

* fibrous dysplasia

* eosinophilic granuloma (histocytosis)

* multiple myeloma

29
Q

Tumor immunostatins:LANGERHANS CELL HISTIOCYTOSIS

A

S100, +CD1A

30
Q

Tumor immunostatins:LYMPHOMA

A

+CD20

31
Q

Tumor immunostatins:EWING SARCOMA

A

+CD99

32
Q

Tumor immunostatins:CHORDOMA

A

Keratin, S100

33
Q

Tumor immunostatins:MYELOMA

A

+CD138

34
Q

Tumor immunostatins:ADAMANTINOMA

A

Keratin

35
Q

What two essential criteria must be met for a limb salvage procedure?

A
  1. local control of the lesion must be at least equal to amputation
  2. the limb that has been saved must be functional
36
Q

What are the types of surgical margins?

A
  1. Intralesional margin - directly through tumor, 100% reoccurrence
  2. Marginal margin - through reactive zone, 25-50% local reoccurrence
  3. Wide margin - cuff of normal tissue, <10% local reoccurence
  4. Radical margin - entire tumor with surrounding compartment is removed
37
Q

External beam radiation is indicated for which scenarios?

A

Local control of:

  1. Ewing sarcoma
  2. Lymphoma
  3. Myeloma
  4. Metastatic bone diseases
38
Q

What are late affects of radiation therapy?

A
  1. post-radiation sarcoms (mostly osteosarcoma, fibrosarcoma, or malignant fibrous histiocytoma)
  2. late stress fractures (subtroch and diaphysis of femur MC)
39
Q

Genetic defect: OSTEOSARCOMA

A

retinoblastoma tumor suppressor gene

40
Q

Genetic defect: EWING SARCOMA

A

t(11,22)

41
Q

Genetic defect: MYXOID LIPOSARCOMA

A

t(12,16)

42
Q

Genetic defect: SYNOVIAL SARCOMA

A

t(X,18)

43
Q

Genetic defect: MYXOID CHONDROSARCOMA

A

t(9,22)

44
Q

Genetic defect: RHABDOMYOSARCOMA

A

t(1,13) or t(2,13)

Orthopedics (5 decks)

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