Tumor/Path

Question 1

t(X:18)

Answer 1

synovial sarcoma

Question 2

t(12:16)

Answer 2

myxoid liposarcoma

Question 3

pleomorphic cells with high mitotic index, occasional bizarre multinucleated giant cells

Answer 3

malignant fibrous histiocytoma/undifferentiated pleomorphic sarcoma/spindle cell sarcoma

Question 4

CD34 positive stain

Answer 4

dermatofibrosarcoma

Question 5

tumors treated with neoadjuvant chemotherapy, wide resection, adjuvant chemotherapy (2)

Answer 5

MFH, osteosarcoma

Question 6

sunburst new bone formation and aggressive periosteal reaction on radiograph

Answer 6

osteosarcoma

Question 7

smoke in a chimney stack

Answer 7

bone infarct

Question 8

where are chondroblastomas found (2)

Answer 8

epiphyseal or apophyseal regions of bones

Question 9

radiolucent lesion with mineralization and a well-marginated rim of reactive bone

Answer 9

chondroblastoma

Question 10

sheets of immature chondroblasts, chicken-wire matrix calcifications, cobblestone pattern

Answer 10

chondroblastoma

Question 11

treatment with curettage and bone grafting (4)

Answer 11

chondroblastoma, giant cell tumor, chondromyxoid fibroma, osteoblastoma

Question 12

four commonly used chemotherapy agents

Answer 12

doxorubicin, cisplatin, methotrexate, ifosfamide

Question 13

osteoblasts with a small amount of lacy malignant osteoid

Answer 13

intramedullary osteosarcoma

Question 14

Enneking’s 4 radiographic questions

Answer 14

location, tumor-bone interaction, bone-tumor interaction, matrix

Question 15

multiple destructive lesions in middle-aged and older patients (> 40 years old) ddx (3)

Answer 15

metastatic disease, multiple myeloma, lymphoma

Question 16

multiple lytic and oval lesions in young patients (< 30 years old) in the same extremity (1)

Answer 16

hemangioendothelioma

Question 17

multiple destructive lesions in a young child (< 5 years old) ddx (3)

Answer 17

neuroblastoma, Wilms tumor, Langerhans cell histiocytosis

Question 18

multiple destructive lesions in any age group ddx (2)

Answer 18

fibrous dysplasia, Paget disease

Question 19

tumors primarily affecting epiphysis (3)

Answer 19

chondroblastoma, giant cell tumor, clear cell chondrosarcoma

Question 20

tumors primarily affecting metaphysis (3)

Answer 20

osteosarcoma, chondrosarcoma, metastatic disease

Question 21

tumors primarily affecting diaphysis (6)

Answer 21

AEIOUY: adamantimoma, eosinophilic granuloma, infection, osteoid osteoma/osteoblastoma, Ewing sarcoma, myeloma/lymphoma/fibrous dysplasia

Question 22

tumors primarily affecting flat bones (5)

Answer 22

chondrosarcoma, fibrous dysplasia, hemangioma, Paget disease, Ewing sarcoma

Question 23

tumors primarily affecting the anterior column of the spine (2)

Answer 23

giant cell tumor, metastatic disease

Question 24

tumors primarily affecting the posterior column of the spine (2)

Answer 24

osteoid osteoma/osteoblastoma, aneurysmal bone cyst

Question 25

tumors primarily affecting the sacrum (4)

Answer 25

midline: chordoma; eccentric: aneurysmal bone cyst/giant cell/metastatic disease

Question 26

t(2;13)

Answer 26

alveolar rhabdomyosarcoma

Question 27

t(12;22)

Answer 27

clear cell sarcoma

Question 28

t(11;22)

Answer 28

Ewing sarcoma/peripheral neuroectodermal tumor

Question 29

t(9;22)

Answer 29

extraskeletal myxoid chondrosarcoma

Question 30

tumor suppressor genes mutated in osteosarcoma (2)

Answer 30

Rb (35%) and p53 (20-65%)

Question 31

hereditary cancer syndromes associated with osteosarcoma (2)

Answer 31

Li-Fraumeni (p53) and congenital bilateral retinoblastoma

Question 32

hereditary cancer syndromes associated with chondrosarcoma (1)

Answer 32

multiple hereditary exostoses (EXT 1-3)

Question 33

hereditary cancer syndromes associated with malignant peripheral nerve sheath tumor (1)

Answer 33

NF1

Question 34

histological grading is based upon these 3 things

Answer 34

nuclear atypia, pleomorphism, nuclear hyperchromasia

Question 35

nuclear atypia definition

Answer 35

degree of loss of structural differentiation

Question 36

pleomorphism definition

Answer 36

variations in size and shape

Question 37

nuclear hyperchromasia definition

Answer 37

increased nuclear staining

Question 38

most common soft tissue sarcomas in young patients (2)

Answer 38

synovial sarcoma, rhabdomyosarcoma