Primary Malignant Bone Tumors Flashcards
The most common PRIMARY malignancy of bone?
Multiple myeloma
What morphological type of anemia will multiple myeloma cause?
Normochromic, normocytic
Multiple myeloma usually affects adults over age __
40
What part of bone does multiple myeloma begin in?
Bone marrow
Name the malignancy with these lab features: hypercalcemia, hyperuricemia, reversed albumin:globulin ratio, elevated blood urea nitrogen (BUN)
Multiple myeloma
Multiple myeloma will cause a ____ protein in a urinalysis
Bence-Jones
Name 3 key radiographic features of multiple myeloma:
- Bone destruction multiple areas
- Punched-out lesions
- Path fxs
- Endosteal scalloping
- “Rain-drop” skull
Is vertebra plana a common finding in the spine for multiple myeloma?
Yes
T/F: Bone scans are a good diagnostic tool for multiple myeloma
FALSE
Confluence of punched-out lesions
Endosteal scalloping
Solitary form of multiple myeloma? It is soap-bubbly and expansile.
Plasmacytoma
Major DDx of multiple myeloma?
Lytic bone metastasis
The most common PRIMARY bone malignancy in CHILDREN
Osteosarcoma
___ are affected 2:1 with osteosarcoma (sex)
Boys
The bimodal ages for osteosarcoma?
10-25, >50
This bone malignancy affects long bones, particularly metaphyseal regions around the knee
Osteosarcoma
A classic radiographic feature specific to osteosarcoma is?
“Cumulus cloud” appearance
Treatment for osteosarcoma might include ____ chemotherapy
Neoadjuvant
Name two lab features associated with osteosarcoma:
- High alkaline phosphatase
2. High lactate dehydrogenase (LDH)
____ is the third most common primary bone malignancy. It usually affects people over 40, and has grades 1, 2, and 3.
Chondrosarcoma
This bone malignancy likes to affect flat bones (pelvis, ribs, scapula, etc.) and PROXIMAL long bones
Chondrosarcoma
A chondrosarcoma is a lytic lesion with a large soft tissue mass containing scattered calcifications in “________”
Rings and arcs
____ strikes people between ages 5 and 30. It is highly malignant and affects red marrow bones (diaphysis of long bones, pelvis, ribs). Hard to distinguish from some other bone tumors
Ewing’s Sarcoma
Lab features of this bone malignancy will include leukocytosis, anemia, and an elevated ESR. Classic radiographic findings are periosteal response, onion skin, permeative or moth-eaten bone destruction.
Ewing’s sarcoma
What two patterns of bone destruction will Ewing’s sarcoma show?
- Permeative
- Moth-eaten
Name three DDX’s for Ewing’s Sarcoma:
- Osteosarcoma
- Lymphoma
- Osteomyelitis
What were the former names for primary lymphoma of bone? (2)
Reticulum cell sarcoma, Non-Hodgkin’s lymphoma of bone
This malignant bone tumor will be difficult to distinguish from some others. It typically affects the diaphysis of long bones, causes moth-eaten and/or permeative bone destruction, cortical violation, and periosteal response. Can affect ANY age. Often causes path fractures!
Lymphoma (Primary lymphoma of bone)
This malignant bone tumor develops in the primitive cell rests of the embryonic notochord! It is very rare.
Chordoma
The most commonly affected bone by a chordoma?
Sacrum
What bone in the cervical spine is most commonly affected by a chordoma?
C2
Radiographic findings of a chordoma would be similar to what other primary bone malignancy?
Chondrosarcoma
A bone not often talked about, but often affected by a chordoma (behind the sacrum) is called?
Clivus (in skull)
A DDX for a sacral chordoma would be?
Giant cell tumor (benign - also likes sacrum)
