Tumour Ddx Basics Flashcards
What is the differential dx of a mass in 52 yr old?
Pt is over 40 so think…
Mets> myeloma > lymphoma > infection > 1o tumour
What is the differential on a 24 yr old male?
NB he is < 40 yrs so
1o tumour > mets> lymphoma (haematological malignancy) > infection
What are the key features to look at on an xray that help you determine if the lesion is benign or malignant ?
1) matrix.
2) bone- narrow or broad zone of transition ( narrow - well defined , can draw around it and benign) ( broad is not well defined - suggest benign aggressive/ malignant )
3) PERIOSTEAL reaction- linear ( benign) cf spiculated/ sun burst ( malignant )
4) destructive / invasive ( malignant) or expansile / remodelling ( benign )
5) soft tissue mass
What do you look for regarding the matrix of the lesion?
Chondroid- ( cartilage)- popcorn/ fluffy/ stippled
Osteoid- ( bone) - sclerotic/ sun burst/ spiculated
Fibrous- ground glass / fallen leaf/ flame sign
What are the principles of taking a biopsy?
A representative sample obtained through a single sacrificable compartment
What are the stages of biopsy?
Person doing biopsy same as definitive surgeon
Longitudinal incision
Thru single compartment - don’t cross compartments
Maciulous blood haemostasis
Representative sample of tissue
Ability to resect track on definitive surgery
Drain places in same line as skin incision
What are the general mimickers of tumours?
Infection
Ewing’s sarcoma
Telangectatic osteosarcoma
Eosinophilic granuloma
