Sarcomas and Multiple Myeloma: Types and Clinical Features

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Questions and Answers

What is the characteristic pattern of malignant fibroblasts in Fibrosarcoma?

Storiform pattern

Spindle pattern

Pleomorphic pattern

Herringbone pattern (correct)

What is a characteristic of well-differentiated Fibrosarcoma?

Moderate intercellular matrix

Closely resembling normal parent tissue (correct)

Increasing mitosis

Highly anaplastic cells

What is a characteristic of poorly differentiated Fibrosarcoma?

Rare mitosis

Moderate production of collagen

No resemblance to parent tissue (correct)

Resemblance to parent tissue is less pronounced

What is the hallmark of Fibrosarcoma in terms of blood vessels?

Thin walled dilated blood vessels Signup and view all the answers

How does the production of collagen change in poorly differentiated Fibrosarcoma?

It decreases Signup and view all the answers

What is the grade of Fibrosarcoma with moderate mitosis?

Intermediate grade Signup and view all the answers

What is the characteristic of osteosarcoma according to the amount of bone in the lesion?

Bone formation in soft tissue, with little tumor bone, appear as an irregular radiolucency Signup and view all the answers

What is the origin of chondrosarcoma?

From mesenchymal stem cells Signup and view all the answers

What is the early radiographic change of osteosarcoma?

Symmetrically widening of periodontal ligament space Signup and view all the answers

What is the radiographic feature of chondrosarcoma?

Irregular radiolucency with radiopacities Signup and view all the answers

What is the characteristic radiographic appearance of osteoblastic osteosarcoma?

Sun ray or sun burst appearance Signup and view all the answers

What is the type of osteosarcoma that appears as an irregular radiolucency?

Osteolytic Signup and view all the answers

What is the characteristic histopathological feature of chondrosarcoma?

Highly cellular with binucleated cells Signup and view all the answers

What is the result of infiltration of tumor cells in osteosarcoma?

Symmetrically widening of periodontal ligament space Signup and view all the answers

Where is the site of chondrosarcoma in the oral cavity?

Anterior part of the maxilla Signup and view all the answers

What is the characteristic sign seen in chondrosarcoma?

Garrington sign Signup and view all the answers

What is the most common site for Kaposi's sarcoma?

Palate Signup and view all the answers

How many types of osteosarcoma are classified based on histologic features?

3 Signup and view all the answers

What is the age range for Burkitt's lymphoma?

2-14 years Signup and view all the answers

Which of the following is not a characteristic of Ewing's sarcoma?

Slowly growing tumor Signup and view all the answers

What is the type of Kaposi's sarcoma that affects people with AIDS?

Epidemic Kaposi's sarcoma Signup and view all the answers

What is the characteristic of the tumor mass in Burkitt's lymphoma?

Rapidly growing Signup and view all the answers

What is the virus associated with Kaposi's sarcoma?

HHV-8 Signup and view all the answers

What is the characteristic of the cells in Kaposi's sarcoma?

Malignant spindle cells Signup and view all the answers

What is the percentage of cases where the Epstein-Barr viral genome is identified in the neoplastic cells in the Endemic type?

95% Signup and view all the answers

At what age are children most commonly affected by the Endemic type?

7 years old Signup and view all the answers

Which bones are most commonly affected by the Endemic type?

Maxilla and mandible Signup and view all the answers

What is the characteristic appearance of the Histologic features of the Endemic type?

Starry sky appearance Signup and view all the answers

What is the age range for Multiple Myeloma?

40-70 years Signup and view all the answers

Which of the following is a common site for Multiple Myeloma?

Vertebrae and ribs Signup and view all the answers

Study Notes

Sarcomas

Fibrosarcoma: a rapidly growing swelling with a herringbone pattern of malignant fibroblasts, thin-walled dilated blood vessels in poorly differentiated tumors
Fibrosarcoma classification:
- Well-differentiated type (low grade): resembles normal parent tissue, production of collagen, increase intercellular matrix, rare mitoses
- Moderately differentiated type (intermediate grade): less resemblance to parent tissue, less production of collagen, intermediate production of intercellular matrix, moderate mitosis
- Poorly differentiated type (high grade): no resemblance to parent tissue, less production of collagen, decreasing intercellular matrix, increasing mitosis

Osteosarcoma

Character: painful, rapidly growing swelling of the involved bone, producing bulky lesion, facial deformity, paresthesia, looseness of teeth, toothache, bleeding, nasal obstruction, pathologic fracture is common
Types according to radiographs:
- Osteolytic type (destructive type): tumors with little tumor bone, appear as an irregular radiolucency
- Osteoblastic or sclerosing type: much tumor bone produced, resulting in sun-ray appearance
Types according to histologic features:
- Osteoblastic
- Chondroblastic
- Fibroblastic
- Telangiectatic (osteogenic sarcoma)

Chondrosarcoma

Arises from mesenchymal stem cells
Site: ant part of maxilla, remnants of Meckel's cartilage
Radiographic picture: Garrington sign (widening of the periodontal ligament), irregular radiolucency with radiopacities
Histopathology: highly cellular, binucleated cells, lacunae contain more than two cells, pleomorphism, hyperchromatism

Ewing's Sarcoma

Clinical features: occurs in children and young adults, pain, swelling, loosening of teeth, mucosa ulcerates, leucocytosis, fever, and raised ESR and anemia
Mic. Endemic type: common in Africa, affects children of 7 years old
Mic. Non-Endemic type: common in the USA, affects children of 11 years old
Histologic features: monotonous overgrowth of undifferentiated monomorphic lymphoreticular cells, macrophages with clear cytoplasm scattered uniformly throughout the tumor, producing the characteristic starry sky appearance

Multiple Myeloma

Definition: a malignant tumor of bone, arising from cells of bone marrow similar to plasma cells
Etiology: unknown, risk factors include obesity, radiation exposure, family history, and certain chemicals
Clinical features: age 40-70 years, female > male, sites: vertebrae, ribs, skull, ends of long bones, and jaw bones (mandible > maxilla), rapidly growing painful swelling, expansion of the bone, numbness, mobility of teeth, hemorrhage, and pathologic fractures
Histopathology: cells resemble lymphocytes but are larger, intracellular glycogen is noticed, cells are in lobules or sheets

Kaposi's Sarcoma

Definition: a sarcoma caused by HHV-8 in AIDS patients (immunodeficiency)
Clinical features: four sub-types:
- Classic Kaposi's sarcoma: affects older men in regions where KSHV is highly prevalent, slow-growing, and most often affects only the legs
- Endemic Kaposi's sarcoma: most common in Sub-Saharan Africa, more aggressive in children
- Immunosuppression therapy-related Kaposi's sarcoma: occurs in people following organ transplantation, mostly affects the skin
- Epidemic Kaposi's sarcoma: occurs in people with AIDS, many parts of the body can be affected
Histopathology: proliferating malignant spindle cells, slit-like vascular channels

African Jaw Lymphoma (Burkitt's Lymphoma)

Definition: a form of malignant lymphoma in which cancer starts in immune cells called B lymphocytes
Clinical features: age 2-14 years, site: mandible, maxilla, ethmoid and sphenoid sinuses, orbit, and visceral organs
Types: Endemic and Non-Endemic

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Description

Test your knowledge on various types of sarcomas, including fibrosarcoma, osteosarcoma, and Ewing's sarcoma, as well as multiple myeloma. Learn about their clinical features and histopathologic differentiation.