Tumor: Other Lesions Flashcards
What are the two cafe au lait spots and the diseases associated with them
Cali = smooth = NF
Maine = jagged = McCune Albright
NOF
1. XR
2. Presentation
3. Histo
4. Trt
NOF
1. XR = eccentric lesion, tibia often
2. Presentation = incidental!!! or path frx
3. Histo = whorled fibroblasts
4. Trt = obs vs currett BG +/- ORIF
What disease is multiple NOF
Jaffe Campanacci
Name 2 anterior tibial lesions in young people
Osteofibrous dysplasia
- Histo = rimming OB
Adamantinoma
- Histo: nests/glands
Describe imaging osteofibrous dysplasia
Anterior tibia, multiple cortically based bubbles
McCune Albright
- Bone presentation
- Mutation
Polyostotic fibrous dysplasia on 1 side of the body
GNAS
Cafe au lait, endocrine
Fibrous dysplasia
- Age
- Histo
- Bone deformity associated
- Trt
Fibrous dysplasia
- Age - younger
- Histo - Chinese characters
- Bone deformity associated - Shepherd’s crook prox fem
- Trt - ORIF only, NO bone graft!!!
Histo lymphoma
Small round blue
CD 45+
LCA = lymphocytes
Lymphoma imaging + trt
Normal looking bone, huge soft tissue mass
Trt chemo/rads
Myeloma
- Histo
- Imaging
- Additional test
- Trt
Myeloma
- Histo = plasma cells (eccentric nucleus), +CD 45 (like lymphoma), +CD56
- Imaging = punched out lesions (skull)
- Additional test = skeletal survey bc WBBC will be cold
- Trt = chemo/rads
Chordoma
- Cell of origin
- Location
- Histo
Notochord
Midline sacrum
Physaliferous cells - central signet ring surrounded by bubbly cytoplasm
LCH
- Imaging - major 2 manifestations
- Histo
Punched out lesion
Vertebra plana
LH cell (coffee bean nuclei)
Eosinophils
Beirbeck granules on EM (tennis racket)
GCT bone
- Cell of origin
- Location: which bones, where
- Histo
- Additional screening
Epiphysis adults
Distal fem»_space; radius (occasional sacrum)
Histo: giant cells with cells spilled out (choc chip cookies)
Chest for chest mets
GCT bone treatment
Benign but aggressive - curettage w/ adjunct (cryo, phenol)
Denosumab
Mechanism denosumab
mAb RANK-L inhibitor
Stops osteoclasts from working and maturing
Ewing
- Presentation
- Histo
- Genetics
Pres: ST mass in kids, B symptoms (fever, weight loss), high ESR/CRP
Aka can look like infection
Histo = small round blue cells in pseudo rosettes +CD99
11,22 - EWS FLI 1
Double numbers: 11, 22, 99
Ewing
- Most likely stage to present in
- Trt
IIB
Chemo - OR - chemo
Adamantinoma
- Additional screening
- Trt
Chest
Wide excision ONLY
Most common tumors that are metastatic
BLT Kosher Pickle
Breast - blastic
Lung - lytic, distal extremity mets
Thyroid
Kidney
Prostate - blastic
What Mirel score is operative? What are the big factors that contribute (site, pain, lesion, size)
> 8 = OR
Peritroch
Painful
Lytic
2/3 bone width
Difference between ABC and SBC in regards to physis
ABC: expands beyond physeal width
- Multiple fluid filled spaces
SBC: respects width physis
- 1 fluid filled space
Trt ABC vs SBC
ABC: curettage, bone graft
SBC: agitate by aspiration and will heal on own
Paget
- Imaging
- Histo
- Trt
Paget
Imaging: lytic + blastic
On bone scan, see darkening that starts proximal and moves distal
Histo: mosaic bone/cement lines
Trt: bisphos
Name the translocations
1. Ewing
2. Myxoid liposarc
3. Alveolar rhabdo
4. Clear cell
5. Synovial cell
6. Myxoid chondrosarcoma
Name the translocations
1. Ewing - 11,22 EWS FLY1
2. Myxoid liposarc - 12,16 TLS CHOP
Myxing up 12 and 16 in the fatty retrop
3. Alveolar rhabdo - 2,13 PAX FKHR
Pa fucked ma giving 2 13 yr old boys
4. Clear cell - 12,22 EWS ATF
Clearly you have TWO hands: 12, 22
5. Synovial cell - X, 18 SSX
XY 18
6. Myxoid chondrosarcoma - 9,22 EWS
Name the tumor with this immunohistochem
SMA
Desmin
S100
CD34/31
B catenin
SMA = smooth muscle = leiomyosarc
Desmin = skeletal muscle = rhabdo
S100 = nerves = schwannoma, MPNST
CD34/31 = vascular = hemangioma, angiosarc
B catenin = Wnt = fibrosis
Name the tumor with this immunohistochem
CD99
INI 1
EMA
Vimentin
USP6
CD45, LCA
CD99 = Ewings
INI 1 loss = epitheliod
EMA = epi membrane = epitheliod, synovial sarc
Vimentin = soft tissue sarc
USP6 = ABC
CD45, LCA = lymphoma
Toxicity doxorubicin
ACDE
Adrimycin = doxorubicin
C cardiac
E ECHO
Sequelae of Ewings treatment
Leukemia - get CBC
Why does myeloma require a skeletal survey?
Cold on bone scan
Tumors that need a bone marrow biopsy
Small round blue
Ewing
Myeloma
What are the small round blue cell tumors? LERNM (learn em)
Lymphoma
Ewings
Rhabdo
Neuroblastoma
Myeloma
