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37 Cards in this Set
- Front
- Back
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Tumors of infancy
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neuroblastoma
wilms retinoblastoma primitive neuroectodermal tumor myeloproliferative disease (Downs, increases risk of leukemia later) |
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Philadelphia chromosome
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9;22 tyrosine kinase protein always on.
CML, ALL |
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genetic conditions increasing leukemia risk
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Downs, Klinefelter, Turner, NF
Fanconi, Bloom, Diamond-Blackfan anemia, Schawachman, ataxia-telangiectasia, SCID, paroxysmal nocturnal hemoglobinuria, Li-Fraumeni S. |
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CML
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all have Philadelphia chromosome (9;22)
initial chronic phase, , big spleen causing pain, leukocytosis, mild anemia and thrombocytopenia, in 3-4 yrs blast crisis phase begins. all counts rise rapidly with terrible tumor lysis sx |
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Hodgkins
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Lymphoma, mostly teens. childhood, teen, and older adults.
Reed-Sternberg cell (large multiple nuclei) same as seen in mono. painless firm cervical adn supraclavicular lymphadenopathy.ant. mediastinal mass |
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non-Hodgkins lymphoma
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T or B cells. incidence increases steadily throghout life. (Burkitt is most common type). intrathoracic tumor. wheezing teen with mediastinal mass.
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Brain tumors
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medulloblastoma
astrocytoma ependymomoa craniopharyngioma |
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astrocytoma
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40% pediatric brain tumor
can occur anywhere cerebellum most common contrast enhancing nodule in wall of cystic mass Low grade most common (juvenile pilocytic astrocytoma) not aggressive |
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ependymal tumors
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ependymoma is most common
posterior fossa, 6yr non-invasive |
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Choroid plexus tumors
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most common brain tumor if <1yr
intraventricular from chorioid plexus increased ICP |
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Primitive neuroectodermal tumors (PNET)
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metastisize within CNS. medullloblastoma, supratentorial PNET, ependymoblastoma.
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Medulloblastoma
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midline cerebellar
males 5-7yrs increased ICP and cerebellar dysfxn |
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Neuroblastoma
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embryo tumor of sympathetic NS. #3 most common
most common cancer of infants 90% are <5yr prognosis based on histo. most in abdomen, adrenal or retropertoneal ganglia. firm nodular mass causingt abdominal discomfort. Calcified on CT (distinguishes from Wilms) |
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Renal tumors
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Wilms (nephroblastoma)
congenital mesoblastic nephroma nephroblastomatosis multicystic nephroblastoma renal cell carcinoma |
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Wilms Tumor
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no fam hx
favorable and unfavorable histo WAGR, Denys-Drash, Beckwith-Wiedemann abdominal mass, no sx , smooth firm |
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Diff dx abdominal tumors
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Wilms (preschool)
neuroblastoma (preschool) non-Hodgkins lymphoma (>1yr) rhabdomyosarcoma (all) germ cell/teratoma (preschool, teens) hepatoblastoma (school age, teens) hepatoma |
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Wilms syndromes
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WAGR (Wilms, aniridia, GU abnorm, MR)
Denys-Drash early renal failure, pseudohermaphrodism in males Beckwith-Wiedemann |
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Rhabdomyosarcoma
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most common soft tissue tumor
occur anywhere, most common in head and neck presents as mass w/ sx of mass effect |
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Osteosarcoma
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teen during growth spurt
metaphysis of long bones local pain and swelling, often hx of injryu sunburst on XR |
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Ewings sarcoma
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teens
diaphyses of long bones and flat local pain, fever onion skinning on XR, mets to lungs, bones. |
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osteochondroma
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benign bone tumor
manhy asx and unrecognized. childhood metaphysis of long bones distal femur, prox humerus, prox tibia, enlarges as child grows. presents 5-15yr. bony nonpainful mass. |
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enchondroma
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benign hyaline cartilage lesion centrally in bone. asx and occur in hands
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chondroblastoma
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rare
epiphysis long bones teens pain in adjacent joint. hip shoulder knee |
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osteoid osteoma
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small benign bone tumor
5-20yr chronic worsening pain, worst at night any bone. most common prox femur and timbia |
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osteoblastoma
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progressive growing destructive lesion
vertebrae preferred, but anywhwere dull aching pain. |
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fibromas
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fibrous lesions of bone in 40% of kids over 2yrs. defect in ossification, no neoplasm. incidentaloma
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unicameral bone cysts
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3yr-skeletal maturity
fluid filled lesions. some go away. most asx but may cause pathologic fx. prox humerus or femur |
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aneurysmal bone cyst
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up to teens
cavernous space filled with blood and tissue. femur, tibia, spine. progressively growingt pain and swelling |
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fibrous dysplasia
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developmental abnormality with fibrous replacement of cancellous bone.
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eosinophilic granuloma
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boys 5-10
skull, but any bone possible local pain and swelling tenderness and warmth |
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retinoblastoma
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60% unilateral and nonhereditary
only 10% found by screening leukocoria, strabismus, orbital inflammation, hyphema 95% cured |
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Germ Cell tumors
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gonadoblastoma: gonadal dysgenesis adn Y chromosome, failure to fully masculinize external genitalia
Teratoma: masses. Germinomas: intracranial, mediastinum, testes. Sertoli-Leydig, granulosa cell cause feminization or precocious puberty |
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Hepatoblastoma
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<3yrs beckwith-wiedemann
large asx abdominal mass. R lobe of liver. weight loss, anorexia, v, abdmoina pain later. mets to regional lymph nodes and lungs. AFP elevated in most bili, LFT normal anemia common, thrombocytosis common check HBV, HCV |
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Hepatocellular carcinoma
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teens associated with chronic HCV HBV
hepatic mass, abdominal distension, anorexia, weight loss, pain. acute abdominal crisis with rupture and hemoperitoneum. AFP elevated in some.bili normal. FLTs abnormal |
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Hemangiomas
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more in girls, preterm, and S/P CVS. arrise in first yr and grow fast. involute by 15yrs
Kasabach-Merrit: rapidly enlarging lesion, thrombocytopenia, hemolytic anemia. coagulopathy (plt, RBC stuck in hemangioma). |
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Kasabach-Merrit
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rapid enlarging lesion with thrombocytopenia, hemolytic anemia, coagulopathy.
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lymphangiomas and cystic hygromas
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benign lymphatic malformations
most in head and neck intrathoracic lymphatic malfomations acan present as mediastinal mass, pericardial effusion |
