What's the principle demographic for Ewing Sarcoma?
10-15 y/o white male
What are the clinical presentation of Ewing Sarcoma?
Pain, mass formation, inflammation symptoms
What's the metatsatsis profile of Ewing's Sarcoma?
Metastasizes early (lung & bones)
What's the 5-year survival of Ewing's sarcoma post surgery/chemo/radioation therapy?
What's the most common location of ewing's sarcoma?
Diaphysis of long bones of extremties (femur/tibia)
What's radiologic finding of ewing's sarcoma?
"Onionskin layering" of new bone around tumor
What's the cellular pattern of ewing's sarcoma?
- Small round blue cells larger than lymphocytes
- Low mitotic index
What's the staining characteristics of ewing's sarcoma?
PAS+, light/dark pattern
What's the genetic expression of Ewing's sarcomas?
- t(11;22) translocation - PNET & Ewings
- Overexpression of MIC2 gene (CD 99)
What's the difference between Ewing's and PNET?
Homer Wright Rosettes in PNETs
What's the principal demographic of Giant cell tumors of bone?
20-40 y/o Chinese female
What's the metastasis profile of Giant cell bone tumors?
What's the most common location of involvement for giant cell tumors of bone?
- Deisal femur, proxima tibia, distal radius, sacrum
- Metaphyseo-epipyseal portion of bone extending to subchondral/articular cartilage
What's the histological characteristics of giant cell tumors of bone?
Hypercellular with numerous multinucleated ginat cells (look like osteoclasts)
What's the clinical presentation of osteomyelitis?
malaise, chills, fever, leukocutosis, pain
How is osteomyelitis diagnosed?
- biopsy of infected bone
- treat even when no organism is found
What are the most common infectious agents of ostomyelitis?
- Staph aureus - most common in kids
- Salmonella - sickle cell anemia
- IV abuse/GU infections - Gram negatives
What's the treatment for osteomyelitis?
5-25% fail to resolve -_ surgeical removal
Where is the most common site of pyrogenic osteomyelitis?
Metaphysis --> lifting of periostium --> inschemia & necrosis
What's sequestrum & involucrum?
- Sequestrum: bone necrosis
- Invlucrum: new bone formation surrounding sequestrum
What are complications of chronic osteomyelitis?
- Squamous Cell Carcinoma (due to inflammation)
- Amyloidosis (AA)
- Pathologic fractures, endocarditis, sepsis, sarcoma
What are common paths of bacteria to bone?
Hematogenous or direct contact (trauma)
What are bone-related clinical signs of Vitamin D deficiency?
- Widened epophyseal plates (writst, kennes, ankels), decreased mineralization of bone
- Bowing of legs, rosary of ribs, flattening of skull/pectus
- Delayed fontanelle closure, delayed teeth erruption
What are non-bone symptoms of vitamin D deficiency?
Hypocalcemia, heart failure, myelofibrosis, pancytopenia
What's the differnece between osteomalacia and rickets?
- Osteomalacia: adults; softening of bone (osteopenia), increased fracture risk
- No growth plates --> no rickets symptoms
What's the difference between ostomalacia nd osteoporosis?
- Osteomalacia: minerlaization defect; pain possible with hydration of matrix
- Osteoporosis: loss of bone mass; no bone pain
What's the histological difference seen in osteomalacia?
Non-minearlized stains pink vs. violet (darker) in mineralized bone
What is Ollier disease?
What's it associated with?
- multiple enchondromas
- soft tissue hemangiomas (Maffucci sundrome)
What is maffucci syndrome? What risk does it carry?
- Soft tissue hemangiomas in multiple enchondromas
- Increased risk of malignancies (ovarian carcinoma and brain gliomas)
What is fibrous dysplasia of bone?
- benign lesion
- localized developmental arrest of bone growth
What are the clinical presentation of fibrous displasio of bone?
- Monostotic: asymptomatic
- Polyostotic: deformities
What's benign/malignant neoplasm of adipose?
What's benign/malignant neoplasm of blood vessel?
What's benign/malignant neoplasm of smooth muscle?
What's benign/malignant neoplasm of striated muscle?
What's benign/malignant neoplasm of nerve sheath?
neurilemoma/malignant peripheral nerve sheath tumor