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Difference between revisions of "Chondroblastoma"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = | | Image = Chondroblastoma_-_very_high_mag.jpg | ||
| Width = | | Width = | ||
| Caption = | | Caption = Chondroblastoma. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = abundant (chondroid) extracellular material, chondroblasts (variable nuclear morphology (ovoid, folded or grooved), moderate-abundant eosinophilic cytoplasm), +/-calcifications surrounding the cell nests ("chickenwire" appearance) - classic feature, +/-[[giant cells]] | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = | | LMDDx = [[giant cell tumour of bone]], [[chondroma]], well-differentiated [[chondrosarcoma]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 15: | Line 15: | ||
| Gross = | | Gross = | ||
| Grossing = | | Grossing = | ||
| Site = | | Site = growth plate - see ''[[chondro-osseous tumours]]'' | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = "young" - growth plates open | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = painful | ||
| Prevalence = | | Prevalence = | ||
| Bloodwork = | | Bloodwork = | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = | | Prognosis = benign | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Line 35: | Line 35: | ||
*Growth plate lesion. | *Growth plate lesion. | ||
*Sclerotic margin. | *Sclerotic margin. | ||
*"Young" = growth plates open. | *"Young" = growth plates open. | ||
*Most common in teens. | |||
*Typically painful.<ref name=Ref_PCPBoD8_625>{{Ref PCPBoD8|625}}</ref> | *Typically painful.<ref name=Ref_PCPBoD8_625>{{Ref PCPBoD8|625}}</ref> | ||
*Radiographic osteolytic lesion of the epiphysis [http://radiopaedia.org/articles/lytic-bone-lesion-mnemonic] | |||
*Rare, 1 % of all bone tumors | |||
*Benign | |||
*Humerus, tibia, femur | |||
==Gross== | ==Gross== | ||
| Line 47: | Line 52: | ||
Features:<ref name=Ref_WMSP_642>{{Ref WMSP|642}}</ref> | Features:<ref name=Ref_WMSP_642>{{Ref WMSP|642}}</ref> | ||
*Abundant extracellular material - pink on [[H&E stain]] - looks vaguely like cartilage. | *Abundant extracellular material - pink on [[H&E stain]] - looks vaguely like cartilage. | ||
*Sometimes described as 'immature cartilage' (very narrow DDX for this type of cartilage) | |||
*Chondroblasts: | *Chondroblasts: | ||
**Nuclear morphology variable: ovoid, folded or grooved. | **Nuclear morphology variable: ovoid, folded or grooved. | ||
| Line 54: | Line 60: | ||
*+/-[[Giant cells]]. | *+/-[[Giant cells]]. | ||
**May lead to confusion with ''[[giant cell tumour of bone]]''. | **May lead to confusion with ''[[giant cell tumour of bone]]''. | ||
**Not infrequently associated with an aneurysmal bone cyst (33%).<ref>{{Cite journal | last1 = Sepah | first1 = YJ. | last2 = Umer | first2 = M. | last3 = Minhas | first3 = K. | last4 = Hafeez | first4 = K. | title = Chondroblastoma of the cuboid with an associated aneurysmal bone cyst: a case report. | journal = J Med Case Rep | volume = 1 | issue = | pages = 135 | month = | year = 2007 | doi = 10.1186/1752-1947-1-135 | PMID = 17999776 }}</ref> | |||
DDx: | DDx: | ||
| Line 59: | Line 66: | ||
*[[Chondroma]]. | *[[Chondroma]]. | ||
*Well-differentiated [[chondrosarcoma]]. | *Well-differentiated [[chondrosarcoma]]. | ||
*Chondromyxoid fibroma - also has 'immature cartilage' | |||
*[[Aneurysmal bone cyst]] - dont forget that these may be secondary to another lesion. | |||
===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image:Chondroblastoma_-_intermed_mag.jpg | Chondroblastoma - intermed. mag. (WC) | Image:Chondroblastoma_-_intermed_mag.jpg | Chondroblastoma - intermed. mag. (WC) | ||
Image:Chondroblastoma_-_very_high_mag.jpg | Chondroblastoma - very high mag. (WC) | Image:Chondroblastoma_-_very_high_mag.jpg | Chondroblastoma - very high mag. (WC) | ||
Image:Bone Chondroblastoma Medium Power.jpg|Chicken wire calcification. (SKB) | |||
Image:Bone Chondroblastoma High Power.jpg|Chicken wire calcification. (SKB) | |||
Image:Bone Chondroblastoma and Aneurysmal Bone Cyst Low Power.jpg|Immature cartilage surrounded by aneurysmal bone cyst with giant cells. (SKB) | |||
Image:Bone Chondroblastoma With Aneurysmal Bone Cyst - Medium Power.jpg|Immature cartilage (left) abutting aneurysmal bone cyst (right) with giant cells. (SKB) | |||
Image:Bone Chondroblastoma - Medium Power.jpg|Immature cartilage. (SKB) | |||
</gallery> | </gallery> | ||
www: | www: | ||
| Line 70: | Line 83: | ||
*[http://img.medscape.com/pi/emed/ckb/orthopedic_surgery/1230552-1254949-997.jpg Chondroblastoma with "chickenwire" appearance (medscape.com)].<ref name=emed_chondroblastoma>URL: [http://emedicine.medscape.com/article/1254949-diagnosis http://emedicine.medscape.com/article/1254949-diagnosis]. Accessed on: 31 December 2010.</ref> | *[http://img.medscape.com/pi/emed/ckb/orthopedic_surgery/1230552-1254949-997.jpg Chondroblastoma with "chickenwire" appearance (medscape.com)].<ref name=emed_chondroblastoma>URL: [http://emedicine.medscape.com/article/1254949-diagnosis http://emedicine.medscape.com/article/1254949-diagnosis]. Accessed on: 31 December 2010.</ref> | ||
*[http://path.upmc.edu/cases/case494/images/fig2a.jpg Chondroblastoma (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case494.html http://path.upmc.edu/cases/case494.html]. Accessed on: 24 January 2012.</ref> | *[http://path.upmc.edu/cases/case494/images/fig2a.jpg Chondroblastoma (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case494.html http://path.upmc.edu/cases/case494.html]. Accessed on: 24 January 2012.</ref> | ||
*Tumor Library - case with giant cells[http://www.tumorlibrary.com/case/image.jsp?title=Chondroblastoma+-+Distal+femur+-+Photomicrograph&uri=/case/images/3571.jpg] | |||
==IHC== | ==IHC== | ||
| Line 78: | Line 92: | ||
==See also== | ==See also== | ||
*[[Chondro-osseous tumours]]. | *[[Chondro-osseous tumours]]. | ||
*Tumor Library[http://www.tumorlibrary.com/case/list.jsp?order=diagnosis+ASC&diagnosis=Chondroblastoma] | |||
==References== | ==References== | ||