Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by Edward McCarthy, M.D. and prepared by Angelique W. Levi, M.D.
Case 1: A 27 year old man had pain in his wrist for six months
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
Week 41: Case 1
A 27 year old man had pain in his wrist for six months. A radiograph demonstrated an expansile lytic lesion at the distal end of his ulna. There was no mineralization in the mass. A biopsy was performed.images/5.14.01.EMCxray1.jpg
images/5.14.01.EMCcase1a.jpg
images/5.14.01.EMCcase1b.jpg
images/5.14.01.EMCcase1c.jpgCorrect
Answer: Small cell osteosarcoma
Histology: Although the radiograph demonstrates an actively destructive lesion, this case lacks mineralization, which is occasionally present in small cell osteosarcomas radiographically. Histologically the lesion shows sheets of small round blue cells. In addition, there are areas of pink osteoid formation, which is intimately related to the neoplastic cells. In areas the osteoid assumes a lace-like pattern. Small cell sarcomas are small round blue cell tumors with osteoid production. The cell population is similar to that present in Ewing’s sarcomas. Occasionally, the tumor cells express CD99, a marker for tumors in the Ewings/PNET group.
Discussion: Conventional osteosarcomas, by contrast, show sheets of pleomorphic cells with spindle cell components in areas. Often cartilage is present.
Histologically, the neoplastic cells are similar or identical to those present in Ewing’s sarcoma. However, the presence of neoplastic osteoid identifies this lesion as a small cell osteosarcoma. Therefore, lesions composed of small round cells should be sampled adequately to determine the presence of osteoid.
Giant cell tumor is a lesion that has an identical radiographic pattern to the present case. The differential with this lesion is primarily a radiologic one. Giant cell tumors show a characteristic histology of multinucleated giant cells admixed with stromal cells.
Incorrect
Answer: Small cell osteosarcoma
Histology: Although the radiograph demonstrates an actively destructive lesion, this case lacks mineralization, which is occasionally present in small cell osteosarcomas radiographically. Histologically the lesion shows sheets of small round blue cells. In addition, there are areas of pink osteoid formation, which is intimately related to the neoplastic cells. In areas the osteoid assumes a lace-like pattern. Small cell sarcomas are small round blue cell tumors with osteoid production. The cell population is similar to that present in Ewing’s sarcomas. Occasionally, the tumor cells express CD99, a marker for tumors in the Ewings/PNET group.
Discussion: Conventional osteosarcomas, by contrast, show sheets of pleomorphic cells with spindle cell components in areas. Often cartilage is present.
Histologically, the neoplastic cells are similar or identical to those present in Ewing’s sarcoma. However, the presence of neoplastic osteoid identifies this lesion as a small cell osteosarcoma. Therefore, lesions composed of small round cells should be sampled adequately to determine the presence of osteoid.
Giant cell tumor is a lesion that has an identical radiographic pattern to the present case. The differential with this lesion is primarily a radiologic one. Giant cell tumors show a characteristic histology of multinucleated giant cells admixed with stromal cells.
