Cartilage
Cartilage is a type of connective tissue that does not commonly come across the pathologist's desk.
It comes in three flavours:[1][2]
- Hyaline cartilage, e.g. trachea.
- Fibrocartilage, e.g. intervertebral disc.
- 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]
- Synovial chondromatosis.
- Gout.
- Pseudogout.
- Storage disorders.
- Granulomatous inflammation.
- Degenerative changes (osteoarthritis).
- Rheumatic disease.
- Diffuse tenosynovial giant-cell tumour.
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.
- Chondrocytes:
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.
General
- Benign.
- Malignant transformation rare <5%.[7]
- Classically location: knee.[7]
- 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:
Microscopic
Features:[7]
- Hyaline cartilage +/- lobular surface.
- +/-Lacunae with binucleate cells.
- +/-Nuclear atypia - moderate to severe.[8]
- +/-Synovial hyperplasia - ribbon like tissue with an epithelium that has eosinophilic cytoplasm.
- Bone.
DDx:
Images
www:
- Synovial chondromatosis (rsna.org).
- Synovial chondromatosis - low mag. (rsna.org).
- Synovial chondromatosis (webpathology.com).
- Loose body with fibrotic synovial membrane (nih.gov).
Sign out
LOOSE BODIES, RIGHT ELBOW, REMOVAL: - FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.
TISSUE, CAPSULE LEFT ELBOW, REMOVAL: - DEGENERATIVE JOINT DISEASE. - SYNOVIAL HYPERPLASIA WITHOUT SIGNIFICANT INFLAMMATION. - ROUND BODIES CONSISTING OF BENIGN BONE WITH A FATTY MARROW, AND FIBROUS AND CARTILAGINOUS SURFACE, COMPATIBLE WITH LOOSE BODIES. - NEGATIVE FOR MALIGNANCY.
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
References
- ↑ 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.
- ↑ URL: http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm. Accessed on: 2 January 2011.
- ↑ Cormack, David H. (2001). Essential Histology (2nd ed.). Lippincott Williams & Wilkins. pp. 178-9. ISBN 978-0781716680.
- ↑ 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.
- ↑ Cormack, David H. (2001). Essential Histology (2nd ed.). Lippincott Williams & Wilkins. pp. 178. ISBN 978-0781716680.
- ↑ 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.
- ↑ 7.0 7.1 7.2 Murphey, MD.; Vidal, JA.; Fanburg-Smith, JC.; Gajewski, DA.. "Imaging of synovial chondromatosis with radiologic-pathologic correlation.". Radiographics 27 (5): 1465-88. doi:10.1148/rg.275075116. PMID 17848703.
- ↑ URL: http://www.webpathology.com/image.asp?n=3&Case=369. Accessed on: 10 December 2012.