Tumours Flashcards
1
Q
Osteoma (Gardner’s Syndrome)
A
Benign Sclerotic Tumour
- Asymotomatic
- Female 3:1
- Frontal or ethmoid sinus distribution
- Round/oval radiopaque, mostly <2cm
- Small, white, solid, osseous growths off the outer cortex of bone
2
Q
Osteoid Osteoma
A
Benign Sclerotic Tumour
- 10-15 years
- Male 2:1
- Proxima Femur, Tibia, Lumbar Spine (pedicle)
- Lucent nidus <1cm (nidus = vascularised fibrous connective tissue)
- Relieved by asprin
- Reactive sclerosis, cortical thickening, solid periosteal reaction
3
Q
Brodie’s Abscess
A
Benign Lucent Tumour
- Lesion is close to growth plates
- Lucency greater than 1 cm
- Drainage tract toward the epiphysis
4
Q
Bone Island (Enostoma)
A
Benign Sclerotic Tumour
- Ischium, Illium, Sacrum, Proximal femur
- Not in the skull
- Intramedullary location
- Adults
- Round, Radiopaque lesions
- long axis of bone
5
Q
Osteochondroma
A
Benign
- Most common skeletal tumour
- 75% discovered before age 20
- Femur, TIbia, Humerus
- Exostosis = grows form the cortex of bone
- Peduculated, Sessile, Cauliflower presentation
- The lesions begin as growth of new bone off the cortex of long bones and then cartliage is calcified within the lesion giving a slcerotic and lucent appearance
- These are usually asymptomatic unless obstrucitng internal strucutres
- Multiple Osteochondroma’s = Heriditory Multiple Exostosis
6
Q
Enchondroma
A
Lucent Benign Tumour
- Most common tumour of the hand
- 50% have a calcification of the cartilage in the matrix
- Can progress in to malignant chondrosarcoma
- Lytic, geograpgic lesion occuring in the metaphysis
- Mildly expansive with endosteal scalloping
- Stippled calcification in the matrix
7
Q
Haemangioma
A
Benigns Lucent Tumour
- Female
- >40 years
- Most common tumour of the spine
- Thoracolumbar vertebral body, Skull
- Vertical striations in the vertebral body
DDx.
- Padget’s
- Osteoporosis
8
Q
Fibrous Xanthoma
A
Lucent Benign
- Fibrocortical defect
- 4-8 years <2cm
- Male 2:1
- Posterior medial surface of distal femour most common
- Nonossifying fibroma
- 8-20 years 2-7cm
- Males 2:1
- Distal tibia, dital femur, proximal tibia, humerus, fibula
- Diametaphyseal
- Eccentric, oval lytic lesion with well defined rim of scleorsis
- Thinned cortex
- Soap bubble appearance
9
Q
Simple Bone Cyst
A
Benign Lucent
- Fluid filled cyst lined with fibrous tissue
- 3-14 years of age
- Proximal humerus, Proximal femur
- Truncated lesion starting in the metaphysis and tapering into the diaphysis. It does not cross into the epiphysis
- Soap bubble matrix
- mild endosteal scollaping
- No periosteal reaction
- Fallen fragment sign or hinge fragement sign if fragment isnt completly detached
10
Q
Aneurysmal Bone Cyst
A
Benign Lucent
- Non-neoplastic blood folled cavity
- Female 3:2
- 5-20 years
- Long bones and thoracolumbar spine
- Metaphyseal and diaphyseal
- Rapidly expanding reaching 8-10cm in diameter
- Egg shell rim of sclerosis
- Buttressing of new periosteal bone
- Will no extend into epiphysis of gorwht plate is closed
- Exapansion into vertebral body is knwn as balloon in finger sign
11
Q
Giant Cell Tumour
A
Lucent Benign
- Quasimalignant tumour
- Also known as osteoclastomas
- 5-20% of malignant
- Malignant tumour
- Male 2:1
- Benign
- Female 3:2
- 20-40 years of age after clsure of epiphysis
- Distal femur, proximal tibia, proximal humerus, distal radius
- Distal radius is 99% malignant
- Most common benign tumour of saccrum
- Metaphyseal that can extend into epiphysis
- Eccentric, lytic, geographic, soap bubble matrix, expansive lesion, thinning of cortex
12
Q
Osteosarcoma
A
Malignant Sclerotic
- Abnoormal osteoblastic cells
- 5 types
- Central (conventional)
- Multicentric
- Parosteal (juxtacortical)
- Extraosseous
- Secondary
- Males 2:1
- 10-20 years
- 50% osseous neoplastic lesion (sclerotic), 25% comprised of connective tissue (lytic), 25% are a mixed lesion
- Occur around the knee in the metaphysis
- Metastases to lungs, bones kidneys
- Dense ivory sclerosis filling meduallry cavity, or permitive lytic lesion, poorly defined zone of transition
- Cortical disruption, Aggressive periosteal reaction, bone exapnsion
- Roughened lobulated boarder (cumulus cloud)
- Large soft tissue mass may also ossify
13
Q
Multiple Myeloma
A
Malignant Lucent
- Malignant proliferation of plasma cells that replace bone marrow
- Most common malignnant tumour
- Male 2:1
- Thoracolumbar junction most common
- Diaphysis of long bones (rarelt bellow the knee and elbow)
- Hallmark sign: Osteolytic defects
- sharply circumscribed
- punched out lesions
- skull, pelvis, long bones, clavicle, ribs
- raindrop skull
- uniform size differentiates from lytic metasteses
- endosteal scalloping
- Diffuse osteolytic round/ocal lesions without reactive sclerosis in diaphysis with endosteal scalloping
- Diffuse, unexplained osteoporosis in vertebral bodies
- Wrinkles vertebra sign may be single or multiple
DDx
- Ewing’s sarcoma, Non-hodgkin’s lymphoma,
14
Q
Ewings Sarcoma
A
Malignnat Lucent
- Males 2:1
- Proliferationof primitive round cells
- Long bones are more affected in younger patients
- femur, tibia, humerus
- Flat bones more affected in older patients
- pelvis, ribs
- Most common tumour to metasesise to lungs and and bone
- Diaphyseal apressive lucent lesion
- Permative with wide xone of transition
- Periosteal raction = sunburst and codmans triangle
- Cortical saucerisation (shallow concave defect on outer cortex)
DDx
- Osteosarcoma
- Osteomyelitis
15
Q
Non-Hodgkin’s Lymphoma
A
Malignant Lucent
- Reticulum cell sarcoma
- Round cell tumour
- Adults 50-80 years
- Males 2:1
- Femur, tibia, humerus diaphysis
- Pelvis, ribs, scapula, vertebrae
- Permative, moth eaten appearence in medullary cavity
- Patch destruction of cortex
- Minimal periosteal reaction, with soft tissue mass
- Vertebral collapse
16
Q
Chondrosarrcoma
A
Malignant Lucent
- Malignant chondrogenic producing cartilage and callagen which often calcifies
- Males 2:1
- Pelvis, femur, humerus
- Most common tumour of hand, sternum, scapula
- large radiolucent lesion wit poorly defined margins
- Expansion/enlargement of bone
- Metaphysis/Diaphysis
- Endosteal scalloping, cortical thinning
- Circular radiolucent giving bubble appearence in matrix
- 2/3 of lesion with a cotton woll appearance (foci of calcification)
- Cortical destruction
17
Q
Fibrosarcoma
A
Malginant Lucent
- 30-50 years
- Female = Male
- Produces varying amounts of malignant fibrous collagen
- 50% occur around the knee
- Eccentric lytic lesion, cortical thinning and endosteal erosion
- permative destruction, wide zone of transition
- Often produces hyge soft tissue mass
18
Q
Metasteses
A
Osteolytic
- Cortical and trabecular destruction
- Lack of bone expansion
- Lack of periosteal response
- Moth-eaten, permative destruction
- Small or absent soft tissue mass
Osteoblastic metasteses
- Localised or diffuse increased bone density
- poorly defined margins
Mixed metasteses
- Combination of features
