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15 Cards in this Set
- Front
- Back
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Lipoma
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Benign uniform proliferation of mature apdipocytes.
Most common soft tissue tumor of adults. Commonly seen in subcutis of proximal extremities and trunk. Soft, mobile, painless (except angiolipomas) lesions. |
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Liposarcomas
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One of the most common sarcomas of adults.
Usually arises in the deep soft tissues of the proximal extremities and retroperitoneum. Four variants: - Well differentiated: indolent - Dedifferentiated: intermediate - Myxoid/round-cell: intermediate - Pleomorphic: aggressive and frequently metastasize. Recognition of lipoblast in the tissue section is important for diagnosis (round clear cytoplasmic vacuoles of lipid that scallop the nucleus). Gross: from large multinodular mass with yellow cut surface. Some admixed white or gelatinous areas may be seen. |
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What is the most common malignant tumor of the bone?
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A metastasis.
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What type of bone cancer does Gaucher's disease cause? Paget's disease?
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Sarcoma. Sarcoma.
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c/c osteoblastoma and osteoid osteoma
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Osteoid osteomas are <2 cm, posterior spine, appendicular skeleton; localized pain that is relieved by NSAIDs, worst at NIGHT.
Osteoblastomas are >2 cm; pain is dull, achy and is NOT relieved by NSAIDs; involve the spine more frequently. |
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Osteosarcoma
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Most common bone sarcoma (20%)
Bimodal age distribution - Children, young adults (75% <20 y.o.) - Elderly (Paget's, radiation) Location: Metaphyseal in youth, flat bones in elderly Path: 70% from genetic causes (Li-Fraumeni, Retinoblastoma, others) Gross: Large tumor with white-tan, gritty cut surface. Hemorrhagic and cystic areas. Infiltrates cortex, lifts periosteum and forms soft tissue masses in the areas surrounding the bone. Histo: Varies, hyperchromatic nuclei, mitoses, necrosis common. |
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What are the bone-forming tumors? Which are benign? Malignant?
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Osteoid osteoma (B)
Osteoblastoma (B) Osteosarcoma (M) |
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Osteochondroma (Exotosis)
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Most common benign bone tumor.
Benign cartilage-capped tumor that is attached to the underlying skeleton by a bony stalk. Adolescents, young adults May develop in any bone in which endochondral ossification happens. Metaphysis. Assumed to arise from displaced fragments of the growth plate. Histo: Mimics an epiphyseal growth plate |
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Enchondromas
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Benign tumors of hyaline cartilage that usually occur in bones with endochondral ossificiation.
Most common in medullary cavity of small tubular bones of hands/feet, also in metaphysis/diaphysis of larger bones. Adolescents and young adults. May erode (but not invade) bone cortex; lesion usually solitary. CP: pathological fracture. Gross: lytic, lobulated appearance, ring-like calcifications. Histo: the border of an enchondroma with surrounding cortex is sharp. No cytological atypia of chondrocytes is seen. |
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Ollier's disease and Mafucci's syndrome
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Multiple enchondromas.
Ollier's: may develop osteosarcoma Mafucci's: Multiple enchondromas and hemangiomas of soft tissue and viscera. May develop chondrosarcoma, angiosarcoma and other extraskeletal tumors |
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Chondrosarcoma
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>40 y.o.
Central skeleton (pelvis, scapula, ribs) Met/diaphysis of long bones (femur, humerus) In contrast to enchondroma, chondrosarcoma rarely involves the distal extremities. About 15% of osteosarcomas arise from preexisting enchondroma or osteochondroma. Gross: gray-white nodules glistening filling medullary cavity. Histo: hypercellular compared to chondromas. Pleo, hyperchromasia. Binucleated nuclei are commonly seen. |
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What cancers send mets to bones?
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BLT And a Kosher Pickle
Breast Lung Thyroid Adrenal Kidney Prostate |
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Metastatic tumors to bone
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Most common malignant lesion
May be osteoblastic or osteolytic. |
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Ewing's sarcoma / Primitive neuroectodermal tumors (ES/PNET)
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Frequently histologically indistinguishable
Children and adolescents Diaphyses of long bones, pelvis, soft tissues (11;22) translocation, causes fusion of EWS gene and FLT1. EWS-FLT1 acts as a dominant oncogene --> cell proliferation. Tx: chemo and surgery +/- radiation therapy. |
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DDx of "small round blue cell tumors"
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Ewing's sarcoma/PNET
Lymphoma, non-Hodgkin's Alveolar rhabdomyosarcoma Wilm's Tumor Malignant melanoma (smal cell variant) Small cell carcinoma (poorly differentiated neuroendocrine carcinoma) Mesenchymal chondrosarcoma/Small cell osteosarcoma |
