new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
|
A 24-year-old baseball player visits his doctor with complaints of right arm pain. On questioning, he states that it has hurt for several weeks but he has been ignoring it, attributing to muscle strain. Radiographic examination demonstrates an expansile, lytic proximal right humeral epiphyseal lesion.
Based on the clinical, radiologic, and biopsy findings, the mass and proximal humerus are resected. On gross examination, the mass demonstrates hemorrhagic areas with multiple small spindle-shaped cells. Laboratory tests performed at the same time demonstrate normal serum and calcium levels.
Which of the following is the likely diagnosis?
(A) Aneurysmal bone cyst
(B) Brown tumor
(C) Giant cell tumor
(D) Ewing sarcoma
(E) Osteoid osteoma
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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."
|
| me007
Forum Guru
Topics: 72
Posts: 799
|
a.
|
| new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
|
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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: 151
|
d
___________________
mediocricity aint my style
|
| epica
|
D
|
| new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
|
Guys D is not the Answer
n for Ewing's Sarcoma chromosome is 22
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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."
|
| epica
|
What abiut Brown tumor?
|
| new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
|
Guys Ewing is always with a Onion Skin Appearence.
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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: 724
Posts: 6,388
|
The correct answer to the question above is: C.
- Aneurysmal bone cysts can be difficult to distinguish, although histology would demonstrate multiple blood-filled cysts without spindle-shaped cells.
- A brown tumor can also be difficult to differentiate; however, this lesion occurs in hyperparathyroidism. There is no evidence for hyperparathyroidism in this patient.
- CORRECT: The key factor in determining the nature of a bone neoplasm is knowing the patient's age and region of bone involved. Giant cell tumors are epiphyseal lesions that affect the distal femur, proximal tibia, distal radius and as, in this case, the proximal humerus. This lesion expands the bone, thins the cortex, and has a lytic appearance. Often these are associated with an extra-osseous soft tissue component. There is low malignant potential; however, local recurrence is frequent.
- Ewing sarcomas are diaphyseal lesions and typically occur in a younger age group (5-20 years).
- Osteoid osteomas are benign tumors that classically present with nighttime pain relieved with aspirin because the tumor secretes prostaglandin E2.
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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: 724
Posts: 6,388
|
Giant Cell Tumors
Although the multinucleated giant cell is the characteristic cell type, these lesions have a background network of stromal mononuclear cells. The mononuclear cells are plump and round, oval, or spindle shaped.
On gross inspection, these lesions are characteristically chocolate brown, soft, spongy, and friable. Yellowish-to-orange discoloration due to hemosiderin may be present. Cystic cavities within the tumor are common. Often, these cavities are blood filled.
At histologic analysis, the differential diagnosis includes brown tumors of hyperparathyroidism; aneurysmal bone cysts; and, rarely, chondroblastoma, osteoblastoma, or osteosarcoma.
A female predominance exists, with a female-to-male ratio of 1.3-1.5:1
GCTs occur most commonly in the third decade of life
Approximately 50% of GCTs are located about the knee at the distal femur and proximal tibia, with the proximal humerus and distal radius representing the third and fourth most common sites, respectively
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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: 724
Posts: 6,388
|
This is from Robbins, NEJM Emedicine
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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."
|
| epica
|
Good review for bone section in 5 minutes
THANKS
|
| new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
|
Epica they missed out the Giant or Multinucleated part cos then it will be easier to pick the choice wudn't it. The point was to pick the Hemorrhage n Location at the Epiphyseal plate.
This is a Kaplan Question !!
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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."
|
| epica
|
Thanks
|
| epica
|
Q
An 18-year-old woman has noted pain and swelling of her right distal thigh associated with activity for the past year. She has no history of any trauma. On examination after performing physical exercise, there is tenderness on palpation above the right knee. Radiographs show an expansile, eccentric, lytic lesion located in the metaphysis of the distal femur that is surrounded by a rim of reactive new bone as a host response. Which of the following diseases is she most likely to have?
A Fibrous dysplasia
B Ewing sarcoma
C Chondrosarcoma
D Osteosarcoma
E Aneurysmal bone c
|
| epica
|
E. should be Cyst, sorry
|
| new_n_lost
Forum Hero
Topics: 724
Posts: 6,388
|
B Ewing sarcoma
___________________
"never argue with a fool, they'll bring you down to their level and beat you with experience" 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."
|
| epica
|
|
| epica
|
Ans is E,
|
| shalini.ravi
Forum Senior
Topics: 17
Posts: 151
|
thanks nnl
___________________
mediocricity aint my style
|
|
| |
| | | | | | | | | | | | | | | | | | | | |
Similar forum topics