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Musculoskeletal > Tumour Pathology > Flashcards

Tumour Pathology Flashcards

1
Q

List 4 benign bone tumours

A

Osteochondroma
Enchondroma
Osteoid osteoma
Chondroblastoma

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2
Q

State 3 features of an osteochondroma

A

Bony projection on external surface of bone
Capped by cartilage
Contains marrow cavity continuous with that of the main bone

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3
Q

Which cell is usually the origin of an osteochondroma?

A

Chondrocyte

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4
Q

Where do osteochondromas usually develop?

A

Near epiphysis of long bones

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5
Q

What is the demographic distribution of people affected by osteochondromas?

A

Equal M:F

Mainly young,

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6
Q

State 3 features of an enchondroma

A

Hyaline cartilage tumour
Arises in medullary cavity of bones of hands and feet
May be single or multiple

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7
Q

What is the demographic distribution of people affected by enchondromas?

A

Young adults

More common in M than F

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8
Q

State 4 features of an osteoid osteoma

A

Osteoblastic tumour
Central core of vascular osteoid
Peripheral zone of sclerotic bone
Found in femur, tibia, hands/feet, spine

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9
Q

What is the demographic distribution of people affected by osteoid osteomas?

A

Usually in children and young adults

Males affected more than females

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10
Q

What is the distinct clinical presentation of osteoid osteomas? [3]

A

Dull pain for months
Worse at night
Relieved by aspirin/NSAIDs

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11
Q

What is the prognosis of osteoid osteomas?

A

Resolves without treatment

~ 33 months

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12
Q

Give 3 features of a chondroblastoma

A

Cartilage tumour arising in bone
Can be aggressive
Found at epiphyses of long bones

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13
Q

What is the demographic distribution of people affected by chondroblastomas?

A

Affects people between 10-20

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14
Q

How do chondroblastomas appear on X ray?

A

Spherical osteolytic foci

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15
Q

How are chondroblastomas treated?

A

Curettage + adjuvant liquid nitrogen

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16
Q

List 3 tumours that are benign but locally aggressive

A

Giant cell tumour
Osteoblastoma
Chordoma

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17
Q

State 3 features of giant cell tumours

A

Originates from osteoclasts
Highly vascularised tumour
Commonly affects long bones esp around knee

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18
Q

What is the demographic distribution of people affected by giant cell tumours?

A

More women affected than men

25-40yo

19
Q

How do giant cell tumours appear on Xray?

A

Luscent centres, opaque borders

May expand into soft tissue

20
Q

State 3 features of an osteoblastoma

A

Solitary, self limiting tumour
Produces osteoid and bone
Common in pelvis
and metaphysis/diaphysis of long bones

21
Q

How are osteoblastomas treated?

A

Surgical resection

- curettage

22
Q

What is a chordoma

A

Very rare
Arises from notocord remnants
Presents in midline, often sacrum
Gelatinous, well circumscribed

23
Q

What is the demographic of people commonly affected by chordomas?

A

Older adults; 40+

M:F is 1:2

24
Q

How does a chordoma appear on Xray?

A

Solitary midline lesion + bony destruction

50% have focal calcifications

25
Q

How are chordomas treated?

A

Resection difficult
Radiation therapy
Chemotherapy for late-stage disease

26
Q

List 3 malignant tumour types

A

Osteosarcoma
Chondrosarcoma
Ewing’s sarcoma

27
Q

State 3 features of osteosarcoma

A

COMMONEST PRIMARY MALIGNANT TUMOUR
Derived from malignant osteoblasts; form osteoid
Predisposing conditions include Paget’s (older pts)

28
Q

What is the demographic of people commonly affected by osteosarcoma?

A

Young adults; majority

29
Q

Which areas are most commonly affected by osteosarcomas?

A

Ends of long bones around knee

- rapid growth; mitotic activity

30
Q

What is the most likely route of spread of osteosarcoma?

A

Haematogenous

- tumour in bone invades the highly vascularised bone marrow

31
Q

How does osteosarcoma look on Xray?

A

Raised (Cortmans) triangle off the periosteum

-prone to path. #

32
Q

What is an essential finding, on histology, of osteosarcoma?

A

Osteoid production

33
Q

How are osteosarcomas treated?

A

Pre-op: chemotherapy
Surgical resection
Post-op: chemotherapy

34
Q

What is a chondrosarcoma?

A

2nd most common primary malignant bone tumour

Malignant chondrocytes ; tumour of purely hyaline cartilage

35
Q

How is a chondrosarcoma treated?

A

Wide surgical excision

36
Q

What is Ewings sarcoma?

A

Highly malignant tumour
Peripheral primitive neuroectodermal tumour
Mainly in metaphysis and diaphysis of femur, tibia, humerus
Uncertain cell of origin

37
Q

What is the demographic of people affected by Ewings’?

A

M:F is 3:2

Most common in 2nd decade

38
Q

How does Ewings’ appear histologically?

A

MANY small round blue cells

39
Q

How is Ewing’s treated?

A

Surgery
Radiation therapy
Chemotherapy (also post op as adjuvant)

40
Q

What is an osteolytic lesion?

A

Punched out region of bone loss

41
Q

Which types of metastatic cancers can lead to osteolytic lesions?

A

Thyroid
Breast
Lung (esp SCLC)
Kidney

42
Q

Which cancer is most likely to cause an osteosclerotic lesion in metastatic disease?

A

Prostate

43
Q

What is multiple myeloma?

A

Malignant proliferation of PLASMA CELLS in bone marrow
Appears as osteolytic lesions
- mainly in old age

44
Q

What are the common consequences of multiple myeloma?

A

Renal failure

Destruction of axial skeleton

Musculoskeletal (19 decks)

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