A pediatric oncology team is reviewing pathology, laboratory, and imaging reports for several newly admitted patients. Match each patient's characteristic diagnostic profile to the most accurate underlying solid tumor diagnosis.
- Elevated urine catecholamine metabolites (VMA and HVA); histology demonstrates small round blue cells forming Homer-Wright pseudorosettes.Neuroblastoma
- Normal urine catecholamines in a patient with an asymptomatic unilateral abdominal mass; histology reveals a triphasic pattern of blastemal, stromal, and epithelial elements.Wilms tumor (Nephroblastoma)
- Radiographic evidence of a 'sunburst' periosteal reaction and Codman triangle; histology shows malignant spindle cells producing unmineralized osteoid.Osteosarcoma
- Radiographic evidence of a lamellated ('onion-skin') periosteal reaction in the diaphysis; cytogenetics confirm a t(11;22) translocation.Ewing sarcoma
Answer
The diagnostic profiles match as follows: Elevated catecholamines and Homer-Wright pseudorosettes indicate Neuroblastoma. Triphasic histology and normal catecholamines indicate Wilms tumor. Osteoid production with a sunburst pattern indicates Osteosarcoma. A diaphyseal lesion with an onion-skin pattern and t(11;22) indicates Ewing sarcoma.
Each specific set of clinical, biochemical, and histological findings serves as the pathognomonic triad for a specific pediatric solid tumor, directly guiding diagnosis and treatment staging.
Step-by-Step Solution
Key Concept
Pathologic, radiographic, and biochemical hallmarks of common pediatric solid tumors.