Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Dr. Cimino-Mathews and prepared by Dr. Austin McCuiston.
Clinical history: A 20 year-old male with a lung mass.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Clinical history: A 20 year-old male with a lung mass.
Correct
Answer: Metastatic osteosarcoma
Histology: The lung wedge resection contains a fairly well circumscribed, peripheral nodule comprised of mesenchymal cells with an associated mineralized matrix of osteoid, as well as focal cartilaginous differentiation. The individual cells are spindled to epithelioid with focally prominent nucleoli and a low mitotic rate. There is no necrosis. There is no associated fat or respiratory epithelium in the lesion.
Discussion: This is a metastatic chondroblastic osteosarcoma in a patient with a known history of a tibial primary. Osteosarcomas by definition are sarcomas in which the neoplastic cells produce osteoid; chondroblastic osetosarcomas contain islands or lobules of cartilage with atypical chondrocytes. The differential diagnosis of a cartilage-forming lesion in the lung includes hamartoma and chondroma. Pulmonary hamartomas are typically well-circumscribed, peripheral nodules (although they can occur centrally) that are comprised of mature hyaline cartilage, clefts lined by respiratory epithelium, fat and smooth muscle. Chondromas are typically central and arise from the tracheal or bronchial cartilage; they are benign proliferations of chondrocytes and are generally lobulated. Metastatic sarcomatoid (metaplastic) carcinomas can also contain malignant osseous or cartilaginous components, and clinical history is key in this setting. The radiographic characteristics (central vs. peripheral; circumscribed vs. infiltrative; bone/matrix-producing vs. non-matrix producing) should be taken into consideration with any chondroblastic or osteoblastic lesion.
Reference(s):
-Klein MJ, Siegal GP. Osteosarcoma: anatomic and histologic variants. Am J Clin Pathol. 2006 Apr;125(4):555-81.Incorrect
Answer: Metastatic osteosarcoma
Histology: The lung wedge resection contains a fairly well circumscribed, peripheral nodule comprised of mesenchymal cells with an associated mineralized matrix of osteoid, as well as focal cartilaginous differentiation. The individual cells are spindled to epithelioid with focally prominent nucleoli and a low mitotic rate. There is no necrosis. There is no associated fat or respiratory epithelium in the lesion.
Discussion: This is a metastatic chondroblastic osteosarcoma in a patient with a known history of a tibial primary. Osteosarcomas by definition are sarcomas in which the neoplastic cells produce osteoid; chondroblastic osetosarcomas contain islands or lobules of cartilage with atypical chondrocytes. The differential diagnosis of a cartilage-forming lesion in the lung includes hamartoma and chondroma. Pulmonary hamartomas are typically well-circumscribed, peripheral nodules (although they can occur centrally) that are comprised of mature hyaline cartilage, clefts lined by respiratory epithelium, fat and smooth muscle. Chondromas are typically central and arise from the tracheal or bronchial cartilage; they are benign proliferations of chondrocytes and are generally lobulated. Metastatic sarcomatoid (metaplastic) carcinomas can also contain malignant osseous or cartilaginous components, and clinical history is key in this setting. The radiographic characteristics (central vs. peripheral; circumscribed vs. infiltrative; bone/matrix-producing vs. non-matrix producing) should be taken into consideration with any chondroblastic or osteoblastic lesion.
Reference(s):
-Klein MJ, Siegal GP. Osteosarcoma: anatomic and histologic variants. Am J Clin Pathol. 2006 Apr;125(4):555-81.
