Difference between revisions of "Cartilage"

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It comes in three flavours:<ref name=Ref_WFH4_173-5>{{Ref WFH4|173-5}}</ref><ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm]. Accessed on: 2 January 2011.</ref>
It comes in three flavours:<ref name=Ref_WFH4_173-5>{{Ref WFH4|173-5}}</ref><ref>URL: [http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm]. Accessed on: 2 January 2011.</ref>
#Hyaline cartilage, e.g. trachea.
#Hyaline cartilage, e.g. [[trachea]].
#Fibrocartilage, e.g. intervertebral disc.
#Fibrocartilage, e.g. intervertebral disc.
#Elastic cartilage, e.g. epiglottis.
#Elastic cartilage, e.g. epiglottis.
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*Round cells.  
*Round cells.  


==Hyaline cartilage==
==Differential diagnosis==
===Microscopic===
Cartilage - general for the site:<ref name=pmid17031677>{{Cite journal  | last1 = Krenn | first1 = V. | last2 = Morawietz | first2 = L. | last3 = König | first3 = A. | last4 = Haeupl | first4 = T. | title = [Differential diagnosis of chronic synovitis]. | journal = Pathologe | volume = 27 | issue = 6 | pages = 402-8 | month = Nov | year = 2006 | doi = 10.1007/s00292-006-0866-6 | PMID = 17031677 }}</ref>
*[[Synovial chondromatosis]].
*[[Gout]].
*[[Pseudogout]].
*[[Storage disorders]].
*[[Granuloma|Granulomatous inflammation]].
*Degenerative changes ([[osteoarthritis]]).
*[[Rheumatic joint disease|Rheumatic disease]].
*[[Diffuse tenosynovial giant-cell tumour]].
 
==Normal==
===Hyaline cartilage===
====Microscopic====
Features:<ref name=Ref_EH2_178>{{Ref EH2|178}}</ref>
Features:<ref name=Ref_EH2_178>{{Ref EH2|178}}</ref>
*Chondrocytes within small pockets (lacunae) of extracellular matrix.
*Chondrocytes within small pockets (lacunae) of extracellular matrix.
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Image:
Image:
*[http://en.wikipedia.org/wiki/File:Cartilage_polarised.jpg Hyaline cartilage - polarised (WC)].
<gallery>
Image:Cartilage polarised.jpg | Hyaline cartilage - polarized. (WC)
</gallery>


==Perichondrium==
===Perichondrium===
===Microscopic===
====Microscopic====
Features:
Features:
*Around cartilage.
*Around cartilage.
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==Synovial chondromatosis==
==Synovial chondromatosis==
*[[AKA]] ''synovial osteochondromatosis''.
*[[AKA]] ''synovial osteochondromatosis''.
===General===
{{Main|Synovial chondromatosis}}
*Benign.
**Malignant transformation rare <5%.<ref name=pmid17848703/>
*Classically location: knee.<ref name=pmid17848703>{{Cite journal  | last1 = Murphey | first1 = MD. | last2 = Vidal | first2 = JA. | last3 = Fanburg-Smith | first3 = JC. | last4 = Gajewski | first4 = DA. | title = Imaging of synovial chondromatosis with radiologic-pathologic correlation. | journal = Radiographics | volume = 27 | issue = 5 | pages = 1465-88 | month =  | year =  | doi = 10.1148/rg.275075116 | PMID = 17848703 | URL = http://radiographics.rsna.org/content/27/5/1465.long }}</ref>
**Hip next most common site.
*Usually adults.
*Prevalence: male > female.
 
Note:
*This is a clinicoradiologic diagnosis.
 
===Gross/radiology===
*Intraarticular calcifications.
*Diffuse involvement of the joint.
*+/-Loose bodies in the joint ([[AKA]] ''joint mice'').
 
Image:
*[http://commons.wikimedia.org/wiki/File:ChondromatoseCoude.jpg Synovial chondromatosis (WC)].
*[http://radiographics.rsna.org/content/27/5/1465/F26.expansion.html SC - gross (rsna.org)].
 
===Microscopic===
Features:<ref name=pmid17848703/>
*[[Hyaline cartilage]] +/- lobular surface.
**+/-Lacunae with binucleate cells.
**+/-Nuclear atypia - moderate to severe.<ref>URL: [http://www.webpathology.com/image.asp?n=3&Case=369 http://www.webpathology.com/image.asp?n=3&Case=369]. Accessed on: 10 December 2012.</ref>
*+/-Synovial hyperplasia - ribbon like tissue with an epithelium that has eosinophilic cytoplasm.
*[[Bone]].
 
DDx:
*[[Chondrosarcoma]].
*[[Osteoarthritis]].
 
Images:
*[http://radiographics.rsna.org/content/27/5/1465.long Synovial chondromatosis (rsna.org)].
*[http://radiographics.rsna.org/content/27/5/1465/F45.expansion.html Synovial chondromatosis - low mag. (rsna.org)].
*[http://www.webpathology.com/image.asp?n=1&Case=369 Synovial chondromatosis (webpathology.com)].
 
===Sign out===
<pre>
LOOSE BODIES, RIGHT ELBOW, REMOVAL:
- FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.
</pre>
 
====Micro====
The sections show multiple fragments of tissue consisting of bone covered by hyaline cartilage and associated with synovial hyperplasia.
 
There is no appreciable nuclear atypia or mitotic activity.


=See also=
=See also=

Latest revision as of 04:02, 6 January 2017

Cartilage is a type of connective tissue that does not commonly come across the pathologist's desk.

It comes in three flavours:[1][2]

  1. Hyaline cartilage, e.g. trachea.
  2. Fibrocartilage, e.g. intervertebral disc.
  3. Elastic cartilage, e.g. epiglottis.

General

Features of cartilage:[3]

  • Avascular.
  • Extracellular matrix with bluish tinge.
  • Round cells.

Differential diagnosis

Cartilage - general for the site:[4]

Normal

Hyaline cartilage

Microscopic

Features:[5]

  • Chondrocytes within small pockets (lacunae) of extracellular matrix.
    • Chondrocytes:
      • Spherical nucleus.
      • Prominent nucleolus.
      • Clear cytoplasm.
    • Extracellular matrix:
      • Blue-white appearance on H&E stain -- key feature.

Image:

  • Hyaline cartilage - polarized. (WC)

Perichondrium

Microscopic

Features:

  • Around cartilage.
    • Increased cellular density.
    • Spindle cells with poorly defined cellular borders in an eosinophilic (fibrous) stroma.

Images:

Tumours

Main article: Chondro-osseous tumours

Tumours of cartilage are dealt with in the article chondro-osseous tumours together with bone tumours.

Specific diagnoses

Synovial chondromatosis

  • AKA synovial osteochondromatosis.
Main article: Synovial chondromatosis

See also

References

  1. ↑ Young, Barbara; Lowe, James S.; Stevens, Alan; Heath, John W.; Deakin, Philip J. (2000). Wheaters Functional Histology (4th ed.). Churchill Livingstone. pp. 173-5. ISBN 978-0004881973.
  2. ↑ URL: http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm. Accessed on: 2 January 2011.
  3. ↑ Cormack, David H. (2001). Essential Histology (2nd ed.). Lippincott Williams & Wilkins. pp. 178-9. ISBN 978-0781716680.
  4. ↑ Krenn, V.; Morawietz, L.; König, A.; Haeupl, T. (Nov 2006). "[Differential diagnosis of chronic synovitis].". Pathologe 27 (6): 402-8. doi:10.1007/s00292-006-0866-6. PMID 17031677.
  5. ↑ Cormack, David H. (2001). Essential Histology (2nd ed.). Lippincott Williams & Wilkins. pp. 178. ISBN 978-0781716680.
  6. ↑ URL: http://apbrwww5.apsu.edu/thompsonj/Anatomy%20&%20Physiology/2010/2010%20Exam%20Reviews/Exam%201%20Review/Ch04%20Mineralized%20Connective%20Tissues.htm. Accessed on: 19 September 2012.
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