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Millers > Tumor: Other Lesions > Flashcards

Tumor: Other Lesions Flashcards

1
Q

What are the two cafe au lait spots and the diseases associated with them

A

Cali = smooth = NF
Maine = jagged = McCune Albright

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2
Q

NOF
1. XR
2. Presentation
3. Histo
4. Trt

A

NOF
1. XR = eccentric lesion, tibia often
2. Presentation = incidental!!! or path frx
3. Histo = whorled fibroblasts
4. Trt = obs vs currett BG +/- ORIF

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3
Q

What disease is multiple NOF

A

Jaffe Campanacci

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4
Q

Name 2 anterior tibial lesions in young people

A

Osteofibrous dysplasia
- Histo = rimming OB

Adamantinoma
- Histo: nests/glands

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5
Q

Describe imaging osteofibrous dysplasia

A

Anterior tibia, multiple cortically based bubbles

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6
Q

McCune Albright
- Bone presentation
- Mutation

A

Polyostotic fibrous dysplasia on 1 side of the body
GNAS

Cafe au lait, endocrine

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7
Q

Fibrous dysplasia
- Age
- Histo
- Bone deformity associated
- Trt

A

Fibrous dysplasia
- Age - younger
- Histo - Chinese characters
- Bone deformity associated - Shepherd’s crook prox fem
- Trt - ORIF only, NO bone graft!!!

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8
Q

Histo lymphoma

A

Small round blue
CD 45+
LCA = lymphocytes

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9
Q

Lymphoma imaging + trt

A

Normal looking bone, huge soft tissue mass
Trt chemo/rads

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10
Q

Myeloma
- Histo
- Imaging
- Additional test
- Trt

A

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

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11
Q

Chordoma
- Cell of origin
- Location
- Histo

A

Notochord
Midline sacrum
Physaliferous cells - central signet ring surrounded by bubbly cytoplasm

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12
Q

LCH
- Imaging - major 2 manifestations
- Histo

A

Punched out lesion
Vertebra plana

LH cell (coffee bean nuclei)
Eosinophils
Beirbeck granules on EM (tennis racket)

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13
Q

GCT bone
- Cell of origin
- Location: which bones, where
- Histo
- Additional screening

A

Epiphysis adults
Distal fem&raquo_space; radius (occasional sacrum)
Histo: giant cells with cells spilled out (choc chip cookies)
Chest for chest mets

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14
Q

GCT bone treatment

A

Benign but aggressive - curettage w/ adjunct (cryo, phenol)
Denosumab

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15
Q

Mechanism denosumab

A

mAb RANK-L inhibitor
Stops osteoclasts from working and maturing

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16
Q

Ewing
- Presentation
- Histo
- Genetics

A

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

17
Q

Ewing
- Most likely stage to present in
- Trt

A

IIB

Chemo - OR - chemo

18
Q

Adamantinoma
- Additional screening
- Trt

A

Chest
Wide excision ONLY

19
Q

Most common tumors that are metastatic

A

BLT Kosher Pickle
Breast - blastic
Lung - lytic, distal extremity mets
Thyroid
Kidney
Prostate - blastic

20
Q

What Mirel score is operative? What are the big factors that contribute (site, pain, lesion, size)

A

> 8 = OR
Peritroch
Painful
Lytic
2/3 bone width

21
Q

Difference between ABC and SBC in regards to physis

A

ABC: expands beyond physeal width
- Multiple fluid filled spaces

SBC: respects width physis
- 1 fluid filled space

22
Q

Trt ABC vs SBC

A

ABC: curettage, bone graft

SBC: agitate by aspiration and will heal on own

23
Q

Paget
- Imaging
- Histo
- Trt

A

Paget
Imaging: lytic + blastic
On bone scan, see darkening that starts proximal and moves distal
Histo: mosaic bone/cement lines
Trt: bisphos

24
Q

Name the translocations
1. Ewing
2. Myxoid liposarc
3. Alveolar rhabdo
4. Clear cell
5. Synovial cell
6. Myxoid chondrosarcoma

A

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

25
Q

Name the tumor with this immunohistochem
SMA
Desmin
S100
CD34/31
B catenin

A

SMA = smooth muscle = leiomyosarc
Desmin = skeletal muscle = rhabdo
S100 = nerves = schwannoma, MPNST
CD34/31 = vascular = hemangioma, angiosarc
B catenin = Wnt = fibrosis

26
Q

Name the tumor with this immunohistochem
CD99
INI 1
EMA
Vimentin
USP6
CD45, LCA

A

CD99 = Ewings
INI 1 loss = epitheliod
EMA = epi membrane = epitheliod, synovial sarc
Vimentin = soft tissue sarc
USP6 = ABC
CD45, LCA = lymphoma

27
Q

Toxicity doxorubicin

A

ACDE
Adrimycin = doxorubicin
C cardiac
E ECHO

28
Q

Sequelae of Ewings treatment

A

Leukemia - get CBC

29
Q

Why does myeloma require a skeletal survey?

A

Cold on bone scan

30
Q

Tumors that need a bone marrow biopsy

A

Small round blue
Ewing
Myeloma

31
Q

What are the small round blue cell tumors? LERNM (learn em)

A

Lymphoma
Ewings
Rhabdo
Neuroblastoma
Myeloma

Millers (29 decks)

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