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MSK 2.0 > Pathology Tumours > Flashcards

Pathology Tumours Flashcards

1
Q

three methods to detect genetic abnormalities causing cancer

A
  • karotyping= overview of chromosomal number and structure
  • FISH= detect specific abnormalities and known translocations
  • immunohistochemistry= pigment on antibody to target protein to detect whether it is being produced
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2
Q

examples detected by karotyping

A

synovial sarcoma t(X;18)
alveolar rhabdomyosarcoma t(2;13)
Ewing’s sarcoma t(11;22)

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3
Q

8 examples of benign bone tumours

A
  1. osteochondroma
  2. enchondroma
  3. simple bone cyst
  4. aneurysmal bone cyst
  5. giant cell tumour
  6. fibrous dysplasia
  7. osteoid osteoma
  8. Brodie’s abscess
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4
Q

describe osteochondroma

A

bony outgrowth with cartilaginous cap
can produce local pain
small risk of malignant transformation

benign lesion derived from cartilage, common around the knee (distal femur/proximal tibia), usually adolescence

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5
Q

describe enchondroma

A

intramedullary and metaphysical cartilaginous tumour caused by failure of normal enchondral ossification of the growth plate

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6
Q

what do the lesions in enchondroma look like?

A

Lucent lesions but can undergo mineralisation

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7
Q

what do enchondromas do?

A

can weaken bones causing fracture

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8
Q

where do enchondromas occur

A

femur
humerus
tibia
small bones of hands and feet

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9
Q

management of enchondromas

A

curettage and bone graft

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10
Q

describe a simple bone cyst

A

single cavity fluid-filled cyst in bone

can lead to fractures

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11
Q

where are simple bone cysts usually located?

A

metaphysics of long bones (humerus and femur) but can occur in talus and calcaneus

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12
Q

describe aneurysmal bone cyst

A

contains lots of chambers filled with blood or serum, due to small arteriovenous malformations

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13
Q

where do aneurysmal bone cysts occur?

A

metaphysis of long bones, flat bones (ribs and skull) and vertebral bodies

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14
Q

what can aneurysmal bone cysts lead to?

A

locally aggressive can cause pain and fractures

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15
Q

where do giant cell tumours occur?

A

locally aggressive in metaphyseal and epiphysis of bones

commonly around the knee and distal radius but can occur in spine and pelvis

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16
Q

XR appearance of giant cell tumours (BUZZWORD)

A

soap bubble appearance

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17
Q

does giant cell tumours have potential to metastasise?

A

can metastasise to benign pulmonary GCT

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18
Q

management of giant cell tumour

A

intralesional excision with use of phenol, bone cement or liquid nitrogen to destroy tumour material

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19
Q

management of aggressive giant cell tumour with cortical destruction

A

joint replacement

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20
Q

two types of GCT

A

PVNS (pigmented villonodular synovitis)

GCTS (tendon sheath)

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21
Q

describe fibrous dysplasia

A

genetic mutation resulting in lesions of fibrous tissue and immature bone

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22
Q

what does defective mineralisation in fibrous dysplasia lead to?

A

angular deformities
thinned cortices
shepherd’s crook deformity (BUZZWORD)

23
Q

management of fibrous dysplasia

A

bisphosphonates may reduce pain

internal fixation and cortical bone grafts are used to improve strength

24
Q

describe osteoid osteoma

A

small nidus of immature bone surrounded by sclerotic halo
commonly in adolescence in long bones
inflammatory response leads to pain at night

25
Q

describe Brodie’s abscess

A

hyperparathyroidism, brown tumours, lytic lesion of bone

26
Q

four examples of malignant bone tumours

A

osteosarcoma
chondrosarcoma
fibrosarcoma
Ewing’s sarcoma

27
Q

describe osteosarcoma

A

younger age groups involving bones around the knee and long bones

28
Q

XR of osteosarcoma

A 
Codman's triangle
Sunray speculation (BUZZWORD)
29
Q

describe chondrosarcoma

A

cartilaginous tumour

30
Q

XR appearance of chondrosarcoma

A

popcorn calcification on Xr

31
Q

who presents with fibrosarcoma?

A

young adults

32
Q

define Ewing’s sarcoma

A

malignant tumour of primitive cells in the marrow

small, round, blue cell tumours

33
Q

what is the genetic abnormality in Ewing’s sarcoma

A

t(11;22)

34
Q

who is Ewing’s sarcoma seen in?

A

10-20 associated with fever, raised CRP and swelling

35
Q

management of Ewing’s sarcoma

A

radio and chemo sensitive

36
Q

buzzword for Ewing’s sarcoma

A

onion-peel sign

37
Q

diagnosis of malignant bone tumours

A

bone scan, CT, MRI

biopsy

38
Q

management of malignant bone tumours

A

surgery (wide margins 3-4cm)
amputations
Neo-adjuvant and adjuvant chemo and radiotherapy

39
Q

describe nodular fasciitis

A

benign soft tissue lesion, often of the superficial fascia

presents in any age group, rapid growth, small, occasionally history of preceding trauma

40
Q

describe myositis ossificans

A

evidence of cellular proliferation and bone formation in muscles
commonly in big muscles e.g. quadriceps, gluteus and brachialis
zonation
evidence of preceding trauma

41
Q

where are rheumatoid nodules often found?

A

elbows

42
Q

six examples of soft tissue tumours

A 
ganglion cyst
bursitis
sebaceous cyst
abscess
superficial fibromatoses
deep fibromatosis
43
Q

define ganglion cyst

A

peripheral lump near a joint capsule or tendon sheath- wrist usually
form as part of herniation through capsule or sheath

44
Q

histology of ganglion cyst

A

not a true cyst as no epithelial lining; space with myxoid material

45
Q

ganglion cyst origin?

A

can be development or asa result of underlying damage (Baker’s cyst)

46
Q

appearance of ganglion cyst

A

well-defined, firm and excision may be required

47
Q

define bursitis

A

inflamed bursa usually occurs due to repeated pressure or trauma which results in swelling

48
Q

what do abscesses result from?

A

cellulitis, bursitis, penetrating wound or infection

49
Q

management of abscess

A

antibiotics

incision and drainage

50
Q

example of superficial fibromatoses

A

Dupuytrens (common in 60 year old males, associated with alcohol)

51
Q

what is deep fibromatosis associated with?

A

Gardner’s syndrome (FAP)

52
Q

five tumour of unknown origin

A
  1. Ewing’s sarcoma
  2. synovial sarcoma
  3. pleomorphic undifferentiated sarcoma
  4. GCT (osteoclastoma)
  5. aneurysmal bone cyst
53
Q

describe synovial sarcoma

A

malignant tumour
affects patients 20-40
deep seated mass around knee, chest wall and H&N area

MSK 2.0 (10 decks)

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