Pathology EMQ template.

Name: Elisa Lewington-Gower

Theme: Neoplastic Bone Disease

 

OPTION LIST

 

A	Bone Cyst	I	Leukaemia
B	Chondrosarcoma	J	Multiple Myeloma
C	Ewing’s Sarcoma	K	Ossifying fibroma
D	Enchondroma	L	Osteoblastoma
E	Fibrous Dysplasia	M	Osteoid Osteoma
F	Fibrosarcoma	N	Osteosarcoma
G	Giant Cell Tumour	O	Secondary Metastasis
H	Leiomyosarcoma	P	Teratoma

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A tumour of the middle aged and elderly, affecting mainly shoulder and pelvis. This cartilage producing tumour has X-ray features of lytic lesions with fluffy calcifications and prognosis is good (70% 5 year survival).

 

 

2. This highly aggressive tumour occurring mainly in the under 20s is considered a primitive neuroectodermal tumour (PNET). It involves the diaphysis or metaphysis of long bone and mainly affects the scapulae, pelvis and ribs. X-ray features include lytic and sclerotic lesions and there is a characteristic translocation affecting the c-myc gene.

 

 

3. This tumour occurring mainly in adolescence commonly affects the knee. X-ray findings include sunray spiculation (raising of the periosteum by the tumour causing new bone formation perpendicular to the cortical surface) and Codman’s triangle. The principle histological defining feature is osteoid production.

 

 

4. The most common form of bone tumour, occurring in the over 50s.

 

 

5. This tumour can affect one or several bones, and may involve the ribs, skull or proximal femur most commonly. X-ray findings include ground glass appearance. When associated with endocrine problems and café au lait spots it is termed McCune Albright Syndrome.

 

 

 

ANSWERS

1. B

2. C

3. N

4. O

5. E