Chondro-osseous tumours: Difference between revisions

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'''Chondro-osseous tumours''' occasionally cross the desk of the pathologist.  They are grouped together as [[bone]] may develop from [[cartilage]].
[[Image:Osteosarcoma - very high mag.jpg|thumb|250px|right|A chondro-osseous tumour ([[osteosarcoma]]). [[H&E stain]].]]
'''Chondro-osseous tumours''' occasionally cross the desk of the pathologist.  They are grouped together as [[bone]] may develop from [[cartilage]].  


Primary bone tumours are rare; the most common bone tumour is [[metastases]].<ref name=Ref_WMSP632>{{Ref WMSP|632}}</ref>   
Primary bone tumours are rare; the most common bone tumour is [[metastases]].<ref name=Ref_WMSP632>{{Ref WMSP|632}}</ref>   
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| ?
| ?
| no stains / may be assoc. with [[FAP]]
| no stains / may be assoc. with [[FAP]]
| Image (???)
| [[Image:Osteoma -- intermed mag.jpg |thumb|center|150px| Osteoma. (WC)]]
|-
|-
| [[Osteoid osteoma]]
| [[Osteoid osteoma]]
| osteoblastic rimming
| osteoblastic rimming
| anastomosing bony trabeculae
| anastomosing bony trabeculae
| <= 1.5 cm, metaphysis
| must be <2 cm,<ref name=pmid25224389>{{Cite journal  | last1 = Yalcinkaya | first1 = U. | last2 = Doganavsargil | first2 = B. | last3 = Sezak | first3 = M. | last4 = Kececi | first4 = B. | last5 = Argin | first5 = M. | last6 = Basdemir | first6 = G. | last7 = Oztop | first7 = F. | title = Clinical and morphological characteristics of osteoid osteoma and osteoblastoma: a retrospective single-center analysis of 204 patients. | journal = Ann Diagn Pathol | volume = 18 | issue = 6 | pages = 319-25 | month = Dec | year = 2014 | doi = 10.1016/j.anndiagpath.2014.08.006 | PMID = 25224389 }}</ref> metaphysis
| painful, NSAIDs remove pain, young
| painful, NSAIDs remove pain, young
| IHC / other
| IHC / other
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| osteoblastic rimming
| osteoblastic rimming
| anastomosing bony trabeculae
| anastomosing bony trabeculae
| > 1.5 cm, metaphysis
| must be >1 cm,<ref name=pmid25224389/> often >=2 cm, metaphysis
| not painful
| not painful
| IHC / other
| IHC / other
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==Chondromyxoid fibroma==
==Chondromyxoid fibroma==
===General===
{{Main|Chondromyxoid fibroma}}
*Benign.
*Teenagers or young adults.
 
===Gross===
*Metaphyseal lesion.
*Well-circumscribed.
 
===Microscopic===
Features:<ref name=Ref_WMSP642>{{Ref WMSP|642}}</ref>
*Spindle cells or stellate cells in a myxoid or chondroid stroma.
 
Images:
*[http://www.webpathology.com/image.asp?n=7&Case=331 Chondromyxoid fibroma - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=331&n=8 Chondromyxoid fibroma - high mag. (webpathology.com)].


==Chondrosarcoma==
==Chondrosarcoma==
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=Bone=
=Bone=
==Osteoma==
==Osteoma==
===General===
{{Main|Osteoma}}
*Benign.
*May be associated with [[familial adenomatous polyposis]].
*Normal bone - unusual location/outgrowth.
 
===Microscopic===
Features:
*Normal bone.


==Osteoid osteoma==
==Osteoid osteoma==
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=Other=
=Other=
This section collects stuff that doesn't neatly fit into the ''bone'' or ''cartilage'' category.
This section collects stuff that doesn't neatly fit into the ''bone'' or ''cartilage'' category.
==Osteochondroma==
===General===
*Benign.
*Very common.
*Abnormal outgrowth of bone and cartilage - associated with growth plate.
*Usually present before age 20.<ref name=pmid12873205>{{Cite journal  | last1 = Parkin | first1 = B. | last2 = Bennett | first2 = JC. | last3 = Zaher | first3 = A. | title = Pathologic quiz case: an iliac mass in a 25-year-old woman. Osteochondroma. | journal = Arch Pathol Lab Med | volume = 127 | issue = 8 | pages = e355-6 | month = Aug | year = 2003 | doi = 10.1043/1543-2165(2003)127e355:PQCAIM2.0.CO;2 | PMID = 12873205 | URL = http://www.archivesofpathology.org/doi/full/10.1043/1543-2165%282003%29127%3Ce355:PQCAIM%3E2.0.CO;2}}</ref>


===Gross===
==Notochordal tumors==
Features:
Notochordal tumors arise from notochordal remnants and thus are seen in the clivus or sacrum.
*Metasphyseal lesions.<ref name=medpath>URL: [http://www.medpath.info/MainContent/Skeletal/Bone_07.html http://www.medpath.info/MainContent/Skeletal/Bone_07.html]. Accessed on: 18 September 2012.</ref>
{{Main|Chordoma}}
**Often distal femur, proximal humerus or proximal tibia.<ref name=pmid12873205/>
**Occasionally iliac mass.<ref name=pmid22217414>{{Cite journal  | last1 = Kokavec | first1 = M. | last2 = Gajdoš | first2 = M. | last3 = Džupa | first3 = V. | title = [Osteochondroma of the iliac crest: case report]. | journal = Acta Chir Orthop Traumatol Cech | volume = 78 | issue = 6 | pages = 583-5 | month =  | year = 2011 | doi =  | PMID = 22217414 }}
</ref>
*Mushroom-like shape - with broad or narrow base.


Note:
==Osteochondroma==
*Very unusual in craniofacial bones.<ref name=pmid12873205/>
{{Main|Osteochondroma}}
 
===Microscopic===
Features:<ref name=pmid12873205/>
*Bone - forms base of "mushroom".
*Cartilage - layer usu. thinner in older individuals.
**Lobular arrangement<ref name=upmc_case341>URL: [http://path.upmc.edu/cases/case341/dx.html http://path.upmc.edu/cases/case341/dx.html]. Accessed on: 19 September 2012.</ref> - clusters of 3-12 lacunae (separated by stroma).
**May have mild atypia.
**Nuclear enlargement - up to 5x normal.
*[[Perichondrium]] - covers the cartilage.
**Thin layer of cells - higher cellular density than cartilage.
***Bland spindle cells in a fibrous (eosinophilic) stroma.
 
Notes:
*Benign cartilage - one chondrocyte per lacuna, small and round nucleus, no binucleation.
 
DDx:
*[[Chondrosarcoma]] - esp. in older individuals.
 
Images:
*[http://path.upmc.edu/cases/case341.html Super rare intracranial mesenchymal osteochondroma - several images (upmc.edu)].<ref name=upmc_case341/>


==Diffuse tenosynovial giant-cell tumour==  
==Diffuse tenosynovial giant-cell tumour==  
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