Malignant Bone Tumors

what age is multiple myeloma (plasma cell sarcoma) seen?

those over 50

what is the most common primary malignancy of bone?

multiple myeloma

what causes myeloma?

malignant proliferation of plasma cells infiltrating bone marrow

what are the x-ray findings og multiple myeloma?

punched out lesion or rain drop skull or vertebral plana

what are the lab findings for multiple myeloma?

M spike on immunoelectrophoresis, reverse albumin/globulin ratio, bence jones proteinuria, increased ESR, russell bodies

what is the most common malignancy of bone?

metastasis

what age is lytic metastasis seen?

> 40

what happens with lytic metastasis?

trabeculae is reabsorbed, which turns the bone darker in color

what are the x-ray findings associated with lytic metastasis?

eating away of pedicle or winking owl sign, swiss cheese appearance of skull

what is the lab finding associated with blastic and lyticmetastasis?

increased alkaline phosphatase

what age is blastic metastasis seen in?

> 40

what are the x-ray findings associated with blastic metastasis?

ivory white vertebrae, cannon ball or snowball appearance, no cortical thickening or bone enlargement

what is the most common form of metastasis in people 20-30 yoa?

Hodgkin’s disease

what do patients with hodgkin’s disease present with?

PEL Epstein fever, hepatosplenomegaly, and enlarged lymph nodes

what are the x-ray findings for Hodgkin’s disease?

ivory right vertebra, anterior vertebral body scalloping

what is the special test for hodgkin’s disease?

biopsy for reed sternberg cells

what age is paget’s (osteitis defromans) seen in?

> 50

what are the stages of paget’s disease?

lytic or destructive → combined → blastic → malignany

what is the pathological cell associted with paget’s?

osteoclastic cell

what are the x-ray findings associted with paget’s?

cortical thickening, bone expansion, picture frame vertebra, brim sign in pelvis, bowing deformities

what are the lab findings associted with paget’s?

increased alkaline phosphatase and urinary hydroxyproline

what age is osterosarcoma seen?

10-30

what is the most common malignancy in kids?

ostesarcoma

what are the x-ray findings of osteosarcoma?

periosteal reaction that is spiculated/radiating/sunburst

what age is Ewing’s sarcoma seen?

10-25

where is the location of ewing’s sarcoma?

diaphysis of long bones

what are the x-ray findings of Ewing’s sarcoma?

multi-paralleled onion skin periosteal reaction, bone expansion, codman’s triangle

what can Ewing’s sarcoma mimic?

osteomyelitis

what age is chondroma seen in?

> 40

what is chordoma?

aberrant notochordal cell tumor most commonly found in the sacrum or clivus of occiput