🔹️Papillary type (90%) not associated with Early P53 mutation
♦️Renal BENIGN TUMORS
✔Adenoma
✔Angiomyolipoma
✔Oncocytoma
🔹️The most common type of renal cancer in patients who develop dialysis-associated cystic disease Papillary types
#pathology
Renal

LUNG
▫️90% of lung tumors are carcinoma
▫️metastatic lung tumors more common than primary

ORAL  
▫️most common → squamous cell carcinoma  
     
SALIVARY GLAND
▫️most common benign →  pleomorphic adenoma
▫️most commom malignant →  mucoepidermoid carcinoma

EOSOPHAGUS
most commom →  squamous cell carcinoma

GASTRIC
▫️most common → gastric adenocarcinoma

COLON
▫️polyps are mostly found in colon
▫️juvenile polyps are most common in hamartamatous
▫️most common malignant → colorectal adenocarcinoma (derived from neoplastic adenoma)

APPENDIX
▫️most commom →  carcinoid (neuroendocine)

تجميعة most common tumors مهم للmcq
#pathology

📌Metabolic Bone Ds
1- Paget ds
🔸⬆️ Osteoclast activity
🔸Male ⬆️50 yr
🔸activating mutations in RANK impppp
🔸imppp INactivating mutations in OPG↪️ juvenile paget ds
🔸Measles or RNA Vs may play a role
3 phases :imp
📍osteolytic stage↪️⬆️osteoclast activity
نلقى الخليه فيها 100 nuclei
📍mixed st↪️prominant osteoblast / osteoprogenitor cs
📍osteosclerotic st ↪️ hallmark is mosiac pattern (puzzele like) of lamellar bone

2-Osteoporosis
*due to osteopenia (reduce bone mass)
📍primary : most common form
🔸occurs in postmenopausal / elderly persons
📍secondary : ass with defined cause

3-Rickets & Osteomalacia ↪️⬇️ Vi D
4- HYPERparathyrodism

———————————————————————————

📌Osteomyelitis always secondary to infecton
سؤال شورت نوت جاي من قبل كيف توصل البكتيريا للعظم؟؟
1- infection begins in metaphyseal end (congestion / oedema / exudate of neutrophils)
2- infection spread into endosteum causing periosteitis
3- reach subperiosteal space forming subperiosteal abscesses , penetrate the cortex creating draining skin sinus tract(cloaca)
4-erosion and infarction necrosis of cortex (sequestrum)
formation of new bone surrounds sequestra (involucrum)

📍in vertebral pyogenic osteomyelitis infection begins from Disc (discitis)

📌Complications : septicemia/fracture/sq cell carcinoma/amyloidosis/acute bacterial arthritis

A-Bone Forming Tumors:
1-Benign ➡️Osteoid Osteoma:
🔸⬇️2cm / femur or tibia / sever pain relieved by asprin

2- Benign Aggressive ➡️Osteoblastoma:
🔸⬆️2cm / vertebrae (laminae and pedicles) /pain unresponsive to asprin
📍Both are more common in 10-20yr.
📍malignant transformation is rare.

3-Malignant➡️ Osteosarcoma: Malignant mesenchymal tumor
🔸most common primary malignant T
🔸⬇️20yr / man
🔸elderly ass with paget ds
🔸arise in metaphyseal region (50% near the knee)
🔸RB mutatations 70% of sporadic osteosarcoma
🔸TP53 mutated in individuals with Li fraumeni syndrome
🔸painful enlarging mass
🔸20% of Pt➡️ lung metastasis
🔸Codman triangle is characteristic of osteosarcoma on radiographic image
🔸M/S: bizarre tumor giant cell

B-Cartilage Forming Tumors:
📍characterized by formation of hyaline or myxoid cartilage
1-Osteochondroma:
🔸most common Benign bone tumor
🔸Involve metaphysis of long bone
🔸10-30yr age group / male⬆️
🔸85% solitary & sporadic
🔸as a part of multiple hereditary exostosis syndrome (mutation in EXT1 or EXT2 gene)

2-Chondrosarcoma: malignant tumor

C- Miscellaneous Tumors:
1-Giant cell tumors (osteoclastoma):
🔸benign but locally aggressive
🔸epiphyses of long bones(common around knee)
🔸20-40yr
🔸neoplastic cells are primitive osteoblast that express high level ( RANKL)
2-Ewings sarcooma:
🔸malignant characterized by primitive round cells without obvious differentiation second most common in children
🔸⬇️20yr / boy
🔸highly aggressive
🔸painful mass in diaphyses (especially femur)
🔸homer wright rosettes indicate neuroectodermal differentiation
——————————————-
📍secondary tumors :metastatic cancer to bone more common than primary
📍prostatic tumors are blastic.

📌Rh arthritis :
🔸70% Pt blood contain Anti -CCP Ab
🔸joint fusion (ankylosis)
🔸HLA DR4
🔸80% of individuals have autoantibodies to Fc portion of IgG (rh factor)
🔸all small joint except distal interphalangeal

📌Gout:
🔸 transient attack initiated by monosodium urate crystals
🔸Tophi are the pathognomonic Hallmark of gout

📌 osteoarthritis:
🔸over age 50yr (most imp factor)
🔸 chondrocytes die➡️ loose bodies

📍 osteophytes: mushroom shaped bony outgrown
(Small bony projections at joint margin )

📍 Ganglion & synovial cysts:
🔸 around joint of wrist , pea sized
🔸Myxoid degeneration of C.T
#pathology
Bone

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Name the parasitic worms that cause biliary obstruction ?
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