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Diagnostic Img.2 EX2
Tumors & Trauma & Cumulative from EX 1
| Question | Answer |
|---|---|
| Solitary lytic or blastic in pt. over 40 suggests? | Cancer, consider metastasis and multiple myeloma |
| Solitary diaphyseal lucency in any pt. suggests? | Cancer, consider leukemia and neuroblastoma in kids, and reticuloendothelial cancer in adults |
| Most common skeletal cancer? | lytic metastasis |
| Bilateral symmetry suggests? | normal variant |
| Pt. > 40 | have cancer |
| Pt. < 40 | have benign lesions, exception is teenagers |
| Diffuse osteopenia is a male may be the only sign of? | multiple myeloma |
| Calcified lesions are usually? | benign, except chondrosarcoma |
| Thick sclerotic rim suggests? | benign lesion or fibrous lesions |
| Mets favors and Myloma spares? | Pedicles |
| Long lesions in long bones are usually? | fibrous |
| Most common skeletal malignancy? | metastasis |
| Metastasis travels via? | lymph, blood or body fluids |
| Metastatic area will have what type of cancer cells? | cancer cells from the original lesion. (they are secondary lesions) |
| Types and percentages of metastatic lesions? | 70% are lytic, 20% are blastic, 10% are mixed |
| Most common blastic mets in men? | prostate |
| Most common Blastic mets in woman? | breast |
| Bacon, lettuce & tomatoe w/ketch up & pickles | Breast, lung, thyroid, kidney & prostate |
| Loves the pedicles of the spine? | metastasis |
| Likes the flat bones? (older people) | Metastasis |
| May be the first sign of malignancy? | metastasis |
| Blow out metastasis | generally associated with rapid growth cells |
| Entire structure will be destroyed? | blow out metastasis |
| Blow out metastasis most common from? | lung, kidney, and thyroid |
| Unusual for mets? | go distal to knee or elbow |
| Mets prefers... | flat bones |
| If mets found distal to knee or elbow think... | lung metastasis; also kidneys or thyroid |
| Mets appear as punched out lytic lesions of what size in flat bones? | varying size (ovoid, not good margins) |
| Multiple myeloma will appear as punch out lytic lesions of what size in flat bones? | symmetrical (circular, sharp margins) |
| Blastic mets appears... | opaque, loose (ivory vertebrae) |
| metastasis commonly look | "motheaten"; poorly marginated |
| multiple myeloma involves? | bone marrow |
| multiple myeloma is a maligant tumor of? | plasma cells, arising from a single clone |
| Multiple myeloma accounts for what percentage of primary malignant tumors of bone? | > 40% |
| Most common malignant primary bone tumor? | multiple myeloma |
| Multiple myeloma may arise as single intraosseous tumor called? | plasmacytoma |
| plasmacytomas appear as | soap bubble lesions, not punched out |
| multiple myeloma more often develops as? | multiple painful lesions throughout skeleton |
| multiple myeloma findings | * M spike on serum protein electrophoresis* Diffuse osteopenia in relatively young man* Spinal osteopenia w/compression fx* Multiple lucent lesions in flat & long bone*Proteinuria=Bence Jones |
| multiple myeloma likes flat bones because? | that's where bone marrow is |
| Reticuloendothelial cancers | 1)leukemia 2)lymphoma 3)Multiple myeloma |
| Osteosarcoma found in | teens |
| malignant tumor of bone in which neoplastic osteoid is produced? | osteosarcoma |
| Most common primary malignant bone tumor of mesenchymal derivation? | osteosarcoma |
| how many types of osteosarcomas? | 17 |
| classic type of osteosarcoma? | central osteosarcoma--found in central part of bone like the knee, hip or shoulder |
| uncommon, but kills most of its victims | osteosarcoma |
| deformity is common | osteosarcoma |
| Osteosarcoma is a malignancy of what? | bone (osteocyte) so it is a bone forming tumor |
| Osteosarcoma's periosteal reation? | spiculated or sunburst |
| osteosarcoma may have what associated with it? | soft tissue mass |
| Osteosarcoma's onset? | insidious |
| Osteosarcoma is most common primary malignancy of bone because? | it is of the bone cells |
| multiple myeloma is the most common skeletal malignancy because? | it occurs in the bone marrow |
| arises in adolescents and affects males slightly more that females | osteosarcoma |
| affected sites of osteosarcoma | 1)knee(distal femur or proximal tibia) in 50% of pt. 2)proximal humerus 3)proximal femur 4)pelvis |
| osteosarcoma mostly occur in what part of the bone? | metaphysic |
| may see what periosteal reaction with osteosarcoma? | Codman's triangle |
| what is codman's triangle? | left over periosteal rxn when tumor has moved outside the bone |
| chondrosarcoma | lytic distruction that doesn't cross the SI joint |
| what type of tumor is chondrosarcoma? | malignant cartilaginous tumor of the bone |
| Chondrosarcoma compared with osteosarcoma | less common and less aggressive |
| Staging of chondrosarcoma | most often presents as a low grade-intracompartmental lesion |
| slow to metastasize and may grow to immense proportions | chondrosarcoma |
| typically lytic and with calcifications | chondrosarcoma |
| locations of chondrosarcoma | 1)pelvis(most common) 2)femur 3)shoulder girdle |
| chondrosarcoma of the femur is a secondary chondrosarcoma because... | it arises from pre-existing osteochondroma because it begins to hurt and forms a bursa. Cartilaginous cap undergoes malignant degeneration |
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