Pathology Flashcards by Matthew Turnbull

name the commonest benign bone tumour

osteochondroma

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what happens in an osteochondroma?

bony outgrowth causing pain

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what is an intramedullary and usually metaphyseal cartilaginous tumour caused by failure of normal enchondral ossification at the growth plate called?

enchondroma

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enchondroma XR appearance?

lucent with patchy sclerotic appearance

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what is a single cavity benign fluid filled cyst in a bone called?

simple bone cyst

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simple bone cysts are usually found in who?

children

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what contains lots of chambers which are filled with blood or serum?

aneurysmal bone cyst

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aneurysmal bone cysts are locally __________ causing ________ expansion - painful

aneurysmal bone cysts are locally AGGRESSIVE causing CORTICAL expansion - painful

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on x-ray this benign bone tumour has a characteristic “soap bubble” appearance

giant cell tumour

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giant cell tumour treatment?

intralesional excision with phenol, bone cement or liquid nitrogen

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where do giant cell tumours commonly occur? (2)

knee

distal radius

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name the benign bone tumour:

locally aggressive and also have a predilection for the metaphyseal region but tend to involve the epiphysis and can extend to the subchondral bone adjacent to the joint

giant cell tumour

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name the disease of a bone usually occurring in adolescence where a genetic mutation results in lesions of fibrous tissue and immature bone

fibrous dysplasia

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name the deformity found in fibrous dysplasia

shepherd’s crook deformity

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fibrous dysplasia treatment?

bisphosphonates for pain

internal fixation and grafts for strength

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name the benign bone tumour:

small nidus of immature bone surrounded by an intense sclerotic halo

osteoid osteoma

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in who do osteoid osteomas occur?

adolescence

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predominant clinical feature in osteoid osteoma?

intense constant pain that’s worse at night

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osteoid osteoma treatment?

NSAIDs for pain

may resolve spontaneously or may require CT guided radio frequency ablation

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name the rare form of subacute osteomyelitis that can also present with a lytic lesion of bone

Brodie’s abscess

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name the tumours from hyperparathyroidism that can also present with a lytic lesion of bone

Brown tumour

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metastatic cancer to the bone causes ________ pain - worse at _____

metastatic cancer to the bone causes CONSTANT pain - worse at NIGHT

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malignant primary bone tumours presents in who?

young patients

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malignant primary bone tumours are ___-defined

malignant primary bone tumours are ILL-defined

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malignant primary bone tumours on X-ray are __________ and _____________

malignant primary bone tumours on X-ray are AGGRESSIVE and DESTRUCTIVE

name the most common form of malignant primary bone tumour

osteosarcoma

osteosarcomas are seen in who? and where are they on the body?

younger patients knee is common

metastatic spread of osteosarcoma is via what?

blood but can be lymphatic

what prolongs survival in osteosarcoma?

chemotherapy

name the malignant cartilage producing primary tumour

chondrosarcoma

chondrosarcomas are seen in who? and where are they on the body?

older age group large pelvis and proximal femur

are chondrosarcomas sensitive to chemo- and radio- therapy?

no!

name the fibrous malignant primary bone tumours which tend to occur in abnormal bone (2)

fibrosarcoma and malignant fibrous histiocytoma

fibrosarcona are seen in who?

young patients

state the malignant tumour of primitive cells in the marrow

Ewing's sarcoma 2nd most common primary done tumour and poorest prognosis

what age group is Ewing's sarcoma seen in? what are the clinical signs?

10-20 fever, inflammatory markers, warm swelling

is Ewing's sarcoma radio- and chemo- sensitive?

yes

name the cancer of round cells of the lymphocytic system

lymphoma

other name for primary bone lymphoma

non-hodgkins lymphoma

common places for non-hodgkins lymphoma?

pelvis or femur

name the malignant B-cell proliferation from marrow presenting as a solitary lesion known as a plasmacytoma or multiple osteolytic lesions

myeloma

typical age of those with myeloma?

45-65

multiple myeloma signs and symptoms?

weakness, back pain, bone pain, fatigue and weight loss marrow suppression and anaemia and recurrent infection

how is myeloma diagnosed?

plasma protein electrophoresis

solitary plasmacytoma and multiple myeloma treatments?

solitary plasmacytoma - RADIOTHERPY multiple myeloma - CHEMOTHERAPY

name the 5 cancers that metastases to bone

``` breast prostatic lung renal cell thyroid adenocarcinoma ```

name the bony metastases: large and very vascular lytic “blow out” bony metastases which can bleed tremendously with biopsy or surgery

renal cell

name the bony metastases: lytic

lung

name the bony metastases: sclerotic

prostate

name the bony metastases: blastic (sclerotic) or lytic

breast

painful lesions thought not to be at risk of impending fracture can be treated with _______________ and radiotherapy

painful lesions thought not to be at risk of impending fracture can be treated with BIPHOSPHONATES and radiotherapy

where are soft tissue swellings located to be referred to orthopaedics?

arms or legs

features suggestive of a benign soft tissue swelling?

``` smaller fluctuate in size cystic well-defined fluid filled soft/fatty ```

features suggestive of a malignant soft tissue swelling?

``` larger rapid growth solid ill defined irregular surface lymphadenopathy systemic upset ```

imaging of soft tissue tumours?

MRI or US for cystic or biopsy

name the most common benign soft tissue tumour

lipoma

name the small firm swelling usually found on the flexor tendon sheath of a finger - may or may not be painful and can erode bone if large enough

giant cell tumour of tendon sheath

giant cell tumour of tendon sheath are pigmented and contain multinucleated giant cells true or false?

true

when a giant cell tumour of tendon sheath is in a joint, what is it called?

pigmented villonodular synovitis (PVNS)

malignant soft tissue tumours end in what?

-sarcoma

name the sarcoma: malignant tumour from blood vessels

andiosarcoma

name the sarcoma: fibrous tissue

fibrosarcoma and malignant fibrous histiocytoma

name the sarcoma: fat

liposarcoma

name the sarcoma: malignant tumour of skeletal muscle

rhabdomyosarcoma

name the sarcoma: originates in the synovial lining of joints or tendons

synovial sarcoma

age that sarcomas present?

50-70

what occurs around a synovial joint or a synovial tendon sheath. It may form as a result of herniation or out‐pouching of a weak portion of joint capsule or tendon sheath?

ganglion cyst

3 common sites of bursitis?

patellar bursitis olecranon bursitis bunions (medial 1st metatarsal head)

what can cellulitis, bursitis, penetrating wound or infected sebaceous cysts result in?

abscesses

abscess treatment?

incision and drainage and antibiotics

in who does osteochondritis occur in?

children and young adults - increased physical exercise

name the sites that the followings affects: (a) Freiburg's disease (b) Kohler's disease (c) Kienbock's disease (d) Panner's disease (e) Scheuermann's disease (f) Perthe's disease (g) Osgood Schlatter disease (h) Sever's disease

(a) Freiburg's disease - 2ND METATARSAL HEAD (b) Kohler's disease - NAVICULAR BONE (c) Kienbock's disease - LUNATE OF THE CARPUS (d) Panner's disease - CAPITELLUM OF THE ELBOW (e) Scheuermann's disease - VERTEBRAL COMPRESSION (f) Perthe's disease - HIP (g) Osgood Schlatter disease - TIBIAL TUBERCLE (h) Sever's disease - CALCANEUS

fragmentation with separation of bone and cartilage within a joint is known as what?

osteochondritis dissecans

osteochondritis treatment?

osteotomy

osteochondritis dissecans treatment?

pinning and removal

ischaemic necrosis of bone predominantly in adults defines what?

AVN

AVN causes?

secondary to fracture idiopathic alcoholsim and steroid abuse thrombophilia sickle cell disease antiphospholipid deficiency in SLE

what is caisson's disease?

rare form of AVN decompression sickness from deep-sea diving

what causes patchy sclerosis before subchondral collapse?

AVN - OA occurs after

AVN treatment?

drilling joint replacement fusion