new_n_lost
Forum Hero
Topics: 674
Posts: 6,148
|
A 45-year-old man presents to a physician with back pain and facial pain. Physical examination demonstrates coarse facial features and kyphosis. Laboratory examination is remarkable for elevated alkaline phosphatase. X-ray studies demonstrate skull thickening with narrowing of foramina, and bowing of the femur and tibia. Bone biopsy reveals a mosaic pattern of bone spicules with prominent osteoid seams. Which of the following neoplasms occurs at an increased frequency in patients with this disorder?
A. Astrocytoma
B. Hodgkin's lymphoma
C. Meningioma
D. Non-Hodgkin's lymphoma
E. Osteosarcoma
Explain Ur Answers Plz
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| shalini.ravi
Forum Senior
Topics: 17
Posts: 153
|
e 
___________________
mediocricity aint my style
|
| usmle4me
Forum Elite
Topics: 6
Posts: 283
|
E
|
| new_n_lost
Forum Hero
Topics: 674
Posts: 6,148
|
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
| new_n_lost
Forum Hero
Topics: 674
Posts: 6,148
|
The correct answer is E.
The phrase "mosaic pattern" of newly formed woven bone is a specific tip-off for Paget's disease of bone, and is not seen in other bone conditions. The clinical and radiologic presentations are typical; an increased hat size may also be a clue. In its early stages, Paget's disease is characterized by osteolysis, producing patchwork areas of bone resorption with bizarre, large osteoclasts. In the middle stage of the disease, secondary osteoblastic activity compensates with new bone formation, producing the mosaic pattern. In late Paget's, the bones are dense and osteosclerotic. Paget's disease is suspected to be related to prior viral infection, but the cause remains mysterious. Complications include myelophthisic anemia, high output cardiac failure, pain secondary to nerve compression, deformities secondary to skeletal changes, and in about 1% of patients, osteosarcoma or other sarcoma, typically involving the jaw, pelvis, or femur.
An increased incidence of astrocytomas (choice A) is associated with tuberous sclerosis.
Hodgkin's lymphoma (choice B) is usually a disease of young adults, although older patients may have the lymphocyte-depleted form.
Meningiomas (choice C) are mostly benign tumors that affect adults, especially females. There may be an association with breast cancer, possibly related to high estrogen states.
Non-Hodgkin's lymphoma (choice D) is more common in AIDS and other immunodeficiency states, although the incidence in the immunocompetent is increasing.
___________________
FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
|
|
| |
| | | | | |
