Osteoblastic Verterbral Metastasis

[Kabutar111]

A 75-y-o man comes to the physician because of a 2-week history of moderate low back pain. Physical examination shows tenderness of the back and down each lower extremity on bending forward; there are no neuromuscular abnormalities. Rectal examination shows an enlarged prostate. Serum studies show a markedly increased prostate-specific antigen concentration. An x-ray of the spine shows vertebral collapse at L1 and patchy areas of increased density, consistent with osteoblastic metastases. Vertebroplasty is done to relieve the patient's pain, and a biopsy specimen of the damaged vertebra is obtained.
Histologic examination of the biopsy specimen is most likely to show which of the following findings?

A) Aggregates of proliferating plasma cells and plasmablasts
B) Nests of epithelial cells joined by intercellular bridges and containing keratin pearls
C) Pleomorphic epithelial cells forming duct-like structures
D) Sheets of small oval- to spindle-shaped basophilic cells
E) Sheets of uniform cells divided into lobules by fine fibrous septa containing lymphocytes

explain plz

[doctorF]

C- this is adenocarcinoma of prostate gland... prostate gland cancer metastasizes to vertebrae via the venous plexus around it... B is keratin pearls of squamous cell cancer so cant be it, D is basophil u can never find a basophil in cancer, E is uniform cells, cancer is never uniform cells, they are anaplastic cells, A is agrregates of plasma cell and plasma blasts this feature is of multiple myeloma


i hope im right

[dranant]

Originally Posted by doctorF

C- this is adenocarcinoma of prostate gland... prostate gland cancer metastasizes to vertebrae via the venous plexus around it... B is keratin pearls of squamous cell cancer so cant be it, D is basophil u can never find a basophil in cancer, E is uniform cells, cancer is never uniform cells, they are anaplastic cells, A is agrregates of plasma cell and plasma blasts this feature is of multiple myeloma.............................

[ashishkabir]

This is an excellent question, Dr.K - thanks for posting it. The explanation for the question is extremely informative. Of course I agree - answer = C.

One quick thing though - the sheets of uniform cells (option e) is this characteristic of any disease? The description sounds familiar but I can't place it - its not amyloid is it? Whats with the lymphocytes?

Thanks!