Pathology of Bone Tumors Flashcards
Giant Cell Tumors are found where?
EPIPHYSIS
What two bone tumors are normally found in the METAPHYSIS?
Chondrosarcoma
Osteosarcoma
EWING SARCOMA are found where?
DIAPHYSIS (ALWAYS)
rare benign tumor of mature bone
usually asymptomatic
Osteoma
Age: 40-50 yo
Site: cortical bones of skull and face
X-ray: well-delimited nodule
Osteoma
Prognosis:
good (simple excision)
slow-growing
not invasive
no malignant transformation
Bone tumor that presents with PAINFUL LESIONS
central area of tumor (nidus)
Osteoid osteoma & Osteoblastoma
- osteoblastoma = “giant osteoid osteoma
pain is relieved by ______ in osteoid osteoma where it is not in osteoblastoma
aspirin
20 year old presents with pain around the knee. What benign tumor could it be?
Osteoid Osteoma
Age:teens- twenties
Site: vertebral column, other
Size: > 2 cm
X-ray: radiolucent nidus, less (or no) sclerotic rim
Prognosis: good, if totally excised
Osteoblastoma
most common 1° malignant tumor of bone (20% of 1° bone malignancies); M:F = 1.6:1
Osteosarcoma
If you dont see ____ you can not call it an osteosarcoma.
Osteoid
malignant mesenchymal tumor; neoplastic cells produce osteoid (unmineralized bone matrix); sometimes makes cartilage
Osteosarcoma
usually arises in metaphysis of long bones of extremities
Paget disease, chronic osteomyelitis, prior irradiation, bone infarcts, fibrous dysplasia
aggressive !!!
20% with pulmonary mets at time of diagnosis
Osteosarcoma
grows so rapidly that it destroys other bone ( PAINFUL)
How do you diagnose osteosarcoma?
Need to see Osteoid
Elevation of periosteum
to produce an angle between
surface of involved bone
Osteosarcoma – Codman Triangle
Mushroom with a stalk
Age (young)
Site: Metaphysis
Prognosis: Good if solitary but if multiple you have increased risk of developing chondroSARCOMA
Osteochondroma (Cartialge forming)
Bening tumors of hyaline cartilage; well circomsribed
- Most common in hands an feet
In medullary –>_______
Chondroma
Enchondromas
Most common intra osseous cartilage tumor
Found in metaphyses of tubular bones PARTICULARLY HANDS AND FEET
- young patient
Chondroma
Ollier Disease –> Multiple chondromas
Malignant version of chondroma is chondrosarcoma which is normally located where?
Prognosis –> depends on grade (size are important)
_______ is a tumor of the AXIAL skeleton
Chondrosarcoma
- Small round blue tumors
2. Primative neural tumors derived from a precursor multipotent mesenchymal stem cell ( HOMER WRITE ROSETTES)
- Ewing Sarcoma
2. Primitive Neuroectodermal Tumor (PNET) ( MORE MATURE then above)
Ewing Sarcoma (EWS)
or
Primitive NeuroEctodermal Tumor (PNET
undifferentiated
EWS
Ewing Sarcoma (EWS)
or
Primitive NeuroEctodermal Tumor (PNET
neural differentiation (–> Homer Wright rosettes)
PNET
found in 30 - 50% of children 4-8 yo
probably developmental defect rather than neoplasm
Fibrous Cortical Defect
most arise in metaphysis of distal femur & proximal tibia (most common = knee)
Resolve spontaneously
Scalloped Margin
Fibrous Cortical Defect
curvilinear spicules of immature woven bone (Chinese characters) surrounded by fibroblastic proliferation
Fibrous Dysplasia
Prognosis: good
contains numerous osteoclast-like multinucleated giant cells mixed with mononuclear stromal cells
Arise in the _____
Giant Cell Tumor of Bone
osteoclastoma
Epiphyses of long bones
- Pain in the knee is an example
_______tumors to bone
are at least 20 X more common than primary bone tumors.
Metastatic
Most metastatic lesions are osteolytic;
