Pathology: Soft Tissue Tumours

Question 1

lipoma

Answer 1

benign tumour in fat

Question 2

leiomyoma

Answer 2

benign tumour in smooth muscle

Question 3

rhandomyoma

Answer 3

benign tumour in skeletal muscle

Question 4

most common tumour

Answer 4

leiomyoma - occurs as fibroid in the uterus

Question 5

what is the most common benign tumour in orthopaedic practice

Answer 5

lipoma - can occur in subcutaenous fat or muscle

Question 6

what is a giant cell tumour of tendon sheath (benign)

Answer 6

small firm swelling usually found on the flexor tendon sheath of finger

can erode bone if large enough

Question 7

giant cell tumour of tendon sheath macroscopically

Answer 7

pigmented lesion

Question 8

giant cell tumour of tendon sheath histologically

Answer 8

contain multinucleated giant cells and haemosiderin

Question 9

treatment of giant cell tumour of tendon sheath

Answer 9

excised, high rate of recurrence

Question 10

what is a giant tumour cell known as when in a synovial joint

Answer 10

pigmented villonodular synovitis

Question 11

what is a malignant connective tissue tumour known as

Answer 11

sarcoma

Question 12

angiosarcoma

Answer 12

malignant tumour from blood vessels

Question 13

how do angiosarcomas occur

Answer 13

in older age groups

most commonly as a complication of previous radiotherapy - breast involvement

Question 14

what is a very poorly differentiated fibrosarcoma refered to as

Answer 14

pleomorphic undifferentiated sarcoma

Question 15

where do liposarcomas arise

Answer 15

deep fatty tissues most often in the abdomen, never in the subcutaenous fat

Question 16

what are liposarcomas a rare cause of in the scotrum

Answer 16

scrotal swelling - testes descend embryologically from the abdomen - therefore fat in the testes has an origin from the retroperitoneum where tumours are common

Question 17

where are synovial sarcomas most common

Answer 17

around the knee joint

Question 18

how do synovial sarcomas present on X ray

Answer 18

calcification

Question 19

what can synovial sarcomas be described as

Answer 19

bi phasic

contain both sarcomatous and epithelial elements

Question 20

what recurrent translocation are synovial sarcomas associated with

Answer 20

tX;18

Question 21

what age do sarcomas commonly present in

Answer 21

50 to 70

Question 22

define cyst

Answer 22

lined by epithelium

Question 23

where do ganglion cysts occur

Answer 23

around synovial joint or a synovial tendon sheath

Question 24

what may cause a ganglion cyst

Answer 24

herniation or out pouching of a weak portion of joint capsule or tendon sheath

weakness can be developmental or as a result of underlying joint damage/arthritis with buildup of pressure in the joint

Question 25

treatment of ganglion cyst

Answer 25

excision may be required for discomfort or cosmesis

Question 26

what is a bursa

Answer 26

sac of synovial fluid around a joint

often numerous bursae around joints and bony prominences

Question 27

bursitis

Answer 27

inflamed bursae due to repeated trauma/pressure

Question 28

bursal abscess

Answer 28

bacterial infection of a bursa

Question 29

what may gout cause

Answer 29

bursitis

Question 30

prognosis of bursitis

Answer 30

recurrence may occur and excision may be required but problems can occur with scarring

Question 31

what are sebaceous cysts also known as

Answer 31

epidermal inclusion cysts

formed out of sebaceous glands

Question 32

CF of sebaceous cysts

Answer 32

painless but can cause irritation when caught by clothing

Question 33

what are sebaceous cysts lined by

Answer 33

squamous epithelium that produces abundant keratin

Question 34

what do sebaceous cysts produce when ruptured

Answer 34

a cheesy substance that consists of degenerate keratin

Question 35

what is an abscess

Answer 35

collection of neutrophils, infective and cellular debris +/- infective organism

Question 36

treatment of abscess

Answer 36

large ones are not penetrated by blood vessels therefore antibiotics will not be useful and they require incision and drainage

Question 37

pseudotumour

Answer 37

mimic neoplasms but are in fact reactive/inflammatory lesions

Question 38

what unusual reaction to injury do pseudotumours express

Answer 38

myositis ossificans - formation of bone tissue inside muscle tissue after traumatic injury

nodular fascitis - rapid growth of lesions after trauma

Question 39

what do pseudotumour lesions mimic histologically

Answer 39

malignancy - can be misdiagnosed