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Diagnostic Imaging II- Exam 3 and 4 > Tumors and Tumor-like conditions > Flashcards

Tumors and Tumor-like conditions Flashcards

1
Q

What is the age of occurrence for Ewings Sarcoma?

A

10-25 (peak is 15 years)

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2
Q

What is the age of occurrence for Osteosarcoma?

A

10-25 and over 60

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3
Q

What is the age of occurrence for Giant Cell Tumor?

A

20-40

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4
Q

What is the age of occurrence for Chondrosarcoma?

A

over 50

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5
Q

What is the age of occurrence for Myeloma?

A

50-70

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6
Q

What is the most common primary malignancy for ages 0-14?

A

leukemia

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7
Q

What is the tumor incidence for metastatic disease?

A

75% of all malignancies

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8
Q

What is the tumor incidence of multiple myeloma?

A

most common primary malignant tumor of adults

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9
Q

What is the tumor incidence of osteosarcoma?

A

is the the most common primary malignant tumor in kids

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10
Q

What is the tumor incidence of osteochondroma?

A

most common benign OSSEOUS tumor

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11
Q

What is the tumor incidence of Hemangioma?

A

it is the most common benign SPINAL tumor

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12
Q

What are the points of a lesion in a longitudinal plane?

A

Diaphyseal, metaphyseal, and epiphyseal

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13
Q

What are the positions of a lesion in a horizontal plane?

A

Central/Medullary, Eccentric, Cortical, Parosteal, Soft tissue

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14
Q

What are the patterns of bone destruction?

A

Geographic, Moth-eaten, Permeative

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15
Q

What is the least aggressive pattern of bone destruction?

A

Least aggressive pattern (usually a solitary lesion >1cm

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16
Q

Which type of bone destruction contains numerous small holes in size?

A

Moth-eaten bone destruction

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17
Q

Which is the most aggressive growing bone destructive lesion?

A

Permeative bone destruction

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18
Q

What are the patterns of periosteal reactions?

A

buttressing, single layer, multiple layers/laminated (onion skin), Spiculated (hair on end), Codman’s triangle

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19
Q

What is buttressing/solid periosteal reaction?

A

it is when additional layers of bone are added to the outside (usually associated with slow growing lesions)

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20
Q

What is the laminated/layered/onion skin reaction?

A

multiple layers of new layers of bone; it alternates layers of lucency and opacity

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21
Q

What is the onion skin reaction usually associated with?

A

Ewing’s

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22
Q

What is a spiculated periosteal reaction?

A

linear radiating spicules of new bone

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23
Q

When the spiculated periosteal reaction is perpendicular to bone, what is it called?

A

Hair on End

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24
Q

When the spiculated periosteal reaction radiating from a central focus, what is it called?

A

Suburst

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25
Q

What are spiculated periosteal reactions usually associated with?

A

highly aggressive lesions such as osteosarcoma

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26
Q

What is codman’s triangle?

A

it is a triangular elevation of periosteum seen at the peripheral lesion-cortex junction

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27
Q

T/F: codman’s triangle is one of the most aggressive forms of periosteal reaction

A

True

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28
Q

What are the tumors with cartilage matrix?

A

Enchondroma, Osteochondroma, Chondroblastoma, Chrondomyxoid fibroma, Chondrosarcoma
(Chondro=cartilage=LIGHT BULB)

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29
Q

What are the appearance of cartilage tumors?

A

Ring or Arc like, Flocculent, Small Crystals

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30
Q

What are the tumors with an osseous matrix?

A

Osteoma, Osteoblastoma, Osteochondroma, Osteoid Osteoma, and Osteosarcoma
(Osteo=bone=LIGHT BULB #2)

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31
Q

What are the tumors with a fibrous matrix?

A

Fibrous Dysplasia, Desmoplastic Fibroma, Non-Ossifying Fibroma, Fibrous Cortical Defect, Ossifying Fibroma, and Fibrosarcoma

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32
Q

What is the number 1 imaging modality to use for tumor evaluation?

A

PLAIN FILM

33
Q

What are the most common primary sites of origin for metastasis in women?

A

breast (70%) is the most common with 80% being lytic, 10% blastic, then followed by thyroid, kidney and uterus

34
Q

What are the most common primary sites of origin for metastasis in men?

A

prostate (60%) is the most common with 80% being blastic while lung carcinoma (25%) is mostly lytic

35
Q

What is the most common pathway of metastasis?

A

hematogenous dissemination (blood) is the most common at times via Batson’s venous plexus

36
Q

What are clinical features of Metastatic disease?

A

Most patients are over the 4th decade (over 40, but the fourth decade is 30-40); may have weight loss, anemic, fever; INITIAL SIGN IS PAIN (like in low back) AND PATHOLOGIC FRACTURE

37
Q

What are common sites for metastasis?

A

those areas richest in RED MARROW are most commonly affected?

38
Q

What is the most common site for metastasis?

A

SPINE (40%), 2nd is ribs and toes (28%)

39
Q

what is more common, lytic or blastic?

A

Lytic (75%); Blastic is only 15%

40
Q

What are the top three types of pathological collapse?

A

Metastatic Carcinoma, Multiple Myeloma, and Traumatic Fracture

41
Q

What is the most common pathological collapse diagnosis seen in kids?

A

Eosinophilic Granuloma

42
Q

Is Multiple or Solitary Ivory vertebra more common?

A

Solitary Ivory Vertebra

43
Q

What are the top three most common types of Solitary Ivory Vertebrae?

A

Paget’s Disease, Hodkin’s Lymphoma, Osteoblastic Metastasis

44
Q

What is the common age for Paget’s?

A

over 60

45
Q

What is the common age for Hodgkin’s Lymphoma?

A

ages 20-40

46
Q

What is the common age for Osteoblastic Metastasis?

A

over 40

47
Q

What is Ostepoikilosis?

A

multiple bone islands (form when kids and go dormant in adult life)

48
Q

How common are blow out metastases or expansile bone metastases?

A

only seen in a small number of primary malignancies (ex. red cell carcinoma, thyroid cancer, hepatocellular carcinoma)

49
Q

What does ACRO mean?

A

out in hands and feet

50
Q

What are the MRI Characteristics of Mets?

A

T1 is most sensitive because it has a low signal

T2 is the most variable because it is a slightly high signal

51
Q

What is the most common primary malignancies?

A

multiple myeloma #1, osteosarcoma #2, chondrosarcoma #3, ewing’s sarcoma #4

52
Q

What is multiple myeloma?

A

a malignant proliferation of plasma cells, which infiltrate bone marrow

53
Q

75% of patients with multiple myeloma are between which ages?

A

50-70

54
Q

What is the male:female ration for multiple myeloma?

A

male to female ration 2:1

55
Q

What is the initial cardinal symptom of multiple myeloma?

A

pain is the cardinal symptom

56
Q

What are some significant laboratory findings for multiple myeloma?

A

elevated plasma proteins in 50-60%, protein electrophoresis with “m-spike” confirmatory in 80-90%, bence jones proteinuria in 40%, bone marrow biopsy >10%

57
Q

Where is multiple myeloma seen skeletally?

A

vertebrae, thoracic and lumbars (extra..pelvis, skull, ribs, clavicle, scapula, femur, and humerus)

58
Q

What is solitary plasmacytoma?

A

a localized form of plasma cell proliferation

59
Q

Where is solitary plasmacytoma seen in the body?

A

vertebra > pelvis > skull > sternum > ribs

60
Q

How is solitary plasmacytoma presented?

A

presents typically as a soap bubbly, highly expansile lesion (sparing posterior elements)

61
Q

How much of solitary plasmacytoma will develop into diffuse form?

A

70%

62
Q

What is the osteolytic defect seen with multiple myeloma?

A

RAIN DROP SKULL

63
Q

What is the 2nd most common primary malignant bone tumor overall?

A

Osteosarcoma

64
Q

What is osteosarcoma?

A

a primary malignant tumor or undifferentiated connective tissue which forms neoplastic osteoid

65
Q

What is the most common primary malignant bone tumor in children and young adults?

A

Osteosarcoma

66
Q

What is the male:female ratio for osteosarcoma?

A

male to female ratio is 3:2

67
Q

What is the most common location for osteosarcoma?

A

distal femur (40%); proximal tibia (16%) is #2, proximal humerus (15%) is #3

68
Q

What specific area of the bone is the osteosarcoma most commonly seen?

A

75% occur in the metaphysis next to the growth plate

69
Q

Osteosarcoma commonly mets to the _______

A

Lungs

70
Q

What are the lab findings and pathological features?

A

Sclerotic 50%
Lytic 25%
Mixed 25%

71
Q

What are some radiologic features for osteosarcoma?

A

there is an ill defined dense ivory or sclerotic lesion (>5cm) filling medullary space sunburst periosteal rection/codman’s

72
Q

For osteosarcoma, what type of advanced imaging clearly defines marrow involvement and soft tissue component?

A

MRI (clearly defined marrow is on T1, soft tissue component on T2)

73
Q

What is a chondrosarcoma?

A

a primary malignant tumor of chondrogenic origin (3rd most common primary malignant bone tumor)

74
Q

What % of primary tumors does the chondrosarcoma account for?

A

10%

75
Q

What are the different forms of chondrosarcoma?

A

primary, secondary, central or peripheral

76
Q

What is the common age chondrosarcomas occur?

A

over 50

77
Q

Are chondrosarcomas more prevalent in males or females?

A

males (m:f ratio is 2:1)

78
Q

What are the most common locations for chondrosarcomas?

A

PELVIS (#1), Proximal humerus (#2), Neck of the femur (#3), Ribs and Sternum (#4)

Diagnostic Imaging II- Exam 3 and 4 (2 decks)

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