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Abs MSK CORTEXT - science/paeds/trauma > Pathology > Flashcards

Pathology Flashcards

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1
Q

what is the most common benign bone tumour

A

osteochondroma

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2
Q

what is an osteochondroma

A

bony outgrowth on external surface with a cartilaginous cap

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3
Q

what is the risk of malignant transformation with osteochondroma

A

very small

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4
Q

what is an enchondroma

A

intramedullary an usually metaphyseal cartilaginous tumour

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5
Q

what causes an enchondroma

A

failure of normal enchondral ossification at the growth plate

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6
Q

features of enchondroma

A

lesion usually lucent but can have a pathcy sclerotic appearance

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7
Q

common locations for enchondroma

A

femur, humerus, tibia, small bones of hands and feet

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8
Q

what is a simple bone cyst

A

single cavity benign fluid filled cyst in a bone

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9
Q

what causes a simple bone cyst

A

growth defect from the physis

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10
Q

consequence of simple bone cyst

A

can cause weakness leading to pathological fracture

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11
Q

what is an aneurysmal bone cyst

A

contains lots of chambers which are filled with blood or serum

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12
Q

what causes an aneurysmal bone cyst

A

small arteriovenous malformation

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13
Q

consequence of aneurysmal bone cyst

A

locally aggressive causing cortical expansion and destruction which is usually painful

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14
Q

features of giant cell tumour

A

locally aggressive, predilection for metaphyseal region, tend to involve the epiphysis and can extend into subchondral bone

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15
Q

most common place for giant cell tumour

A

around knee and in distal radius

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16
Q

consequences of giant cell tumour

A

occur after physis has fused and are locally destructive, destroying the cortex
painful and may cause pathological fracture

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17
Q

appearance of giant cell tumour on X-ray

A

soap bubble appearance on Xray

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18
Q

when does fibrous dysplasia happen

A

adolescence where a genetic mutation results in lesions of fibrous tissue and immature bone

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19
Q

what is affected bone like in fibrous dysplasia

A

bone is wider with thinned cortices

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20
Q

consequences of fibrous dysplasia

A

stress fractures can occur

excessive involvement of the proximal femur can lead to a shepherds crook deformity

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21
Q

what is an osteoid osteoma

A

small nidus of immature bone surrounded by an intense sclerotic halo

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22
Q

most common age for osteoid osteoma to occur

A

adolescence

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23
Q

common sites for osteoid osteoma

A

proximal femur, diaphysis of long bones and vertebrae

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24
Q

clinical features of osteoid osteoma

A

intense constant pain, worse at night

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25
Q

what two other conditions may also present with lytic lesions of bone

A

Brodie’s abscess - subacute osteomyelitis

Brown’s tumour - hyperparathyroidism

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26
Q

benign bone tumours

A 
osteochondroma 
enchondroma 
simple bone cyst 
aneurysmal bone cyst 
giant cell tumour 
fibrous dysplasia 
osteoid osteoma
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27
Q

signs of malignant primary bone tumour on Xray

A

aggressive and destructive

  • cortical destruction
  • periosteal reaction
  • new bone formation
  • extension into surrounding soft tissue envelope
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28
Q

most common malignant primary bone tumour

A

osteosarcoma

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29
Q

most common place for osteosarcoma

A

bones around knee (60%)

30
Q

metastatic spread of osteosarcoma

A

usually haematogenous, can be lymphatic

31
Q

what do some people also have at diagnosis of osteosarcoma?

A

10% also have pulmonary mets

32
Q

what is a chondrosarcoma

A

cartilage producing primary bone tumour

33
Q

in what age group does osteosarcoma tend to occur

A

younger

34
Q

in what age group does chondrosarcoma tend to occur

A

older

35
Q

common location for chondrosarcoma

A

pelvis or proximal femur

36
Q

treatment osteosarcoma

A

adjuvant chemo can prolong survival

37
Q

treatment chondrosarcoma

A

not radiosensitive and unresponsive to adjuvant chemo

38
Q

fibrous malignant primary bone tumours

A

fibrosarcoma or malignant fibrous histiocytoma

39
Q

where do fibrous malignant primary bone tumours tend to occur

A

abnormal bone

40
Q

who is affected by fibrosarcoma

A

adolescents

41
Q

what is Ewings sarcoma

A

malignant tumour of primitive cells in the marrow

42
Q

what is the second most prevalent primary bone tumour

A

Ewings sarcoma

43
Q

prognosis in Ewings sarcoma

A

poorest of all malignant primary bone tumours

44
Q

age group for Ewings

A

10-20

45
Q

associated symptoms of Ewings

A

fever
raised inflammatory markers
warm swelling

46
Q

what may Ewings may be misdiagnosed as

A

osteomyelitis

47
Q

treatment of Ewings sarcoma

A

radio and chemo sensitive

48
Q

staging investigations

A

bone scan and CT chest

49
Q

investigations to determine local extent, and involvement of muscles nerves and vessels

A

MRI and CT

50
Q

investigations for diagnosis and grading prior to surgery

A

biopsy

51
Q

which cancers commonly metastasise to bone

A 
breast 
prostate 
lung 
renal cell 
thyroid
52
Q

features of breast mets

A

blastic or lytic

24-26m survival

53
Q

features of prostate mets

A

sclerotic

45% survival 1yr

54
Q

features of lung mets

A

lytic

6m survival

55
Q

features of renal cell mets

A

large and vascular lytic which bleed tremendously

12-18m survival

56
Q

what is lymphoma

A

cancer of round cells of lymphocytic system

57
Q

common location for primary lymphoma

A

pelvis or femur

58
Q

treatment for lymphoma

A

surgical resection

59
Q

metastatic lymphoma survival

A
60
Q

what is myeloma

A

malignant B cell proliferation

61
Q

features of myeloma

A

arises from marrow and can present as a solitary lesion or with multiple osteolytic lesions throughout skeleton

62
Q

typical age group of myeloma

A

45-65

63
Q

clinical symptoms of myeloma

A

weakness, back pain, bone pain, weight loss, fatigue, anaemia, recurrent infection

64
Q

diagnosis of myeloma

A

plasma protein electrophoresis

65
Q

5yr survival myeloma

A
66
Q

features suggestive of benign soft tissue tumour

A 
smaller 
fluctuation in size 
cystic 
well-defined
fluid filled 
soft/fatty lesions
67
Q

features suggestive of neoplasms

A 
larger 
rapid growth 
solid 
ill-defined
irregular surface
associated lymphadenopathy 
systemic upset
68
Q

what is a lipoma

A

neoplastic proliferation of fat

most common benign soft tissue tumour

69
Q

malignant soft tissue tumours

A 
Angiosarcoma 
Fibrosarcoma 
Liposarcoma 
Rhabdomyosarcoma
Synovial sarcoma
70
Q

what is osteochondritis

A

recurrent impact or traction causes bleeding and oedema within the bone, resulting in capillary compression
bone necrosis ensues
tends to occur in children and young adults

71
Q

what is avascular necrosis

A

ischaemic necrosis of bone predominantly in adults

can be secondary to fractures

Abs MSK CORTEXT - science/paeds/trauma (3 decks)

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