Difference between revisions of "Cartilage"

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Line 51: Line 51:
*Usually adults.
*Usually adults.
*Prevalence: male > female.
*Prevalence: male > female.
Note:
*This is a clinicoradiologic diagnosis.


===Gross/radiology===
===Gross/radiology===
*Intraarticular calcifications.
*Intraarticular calcifications.
*Diffuse involvement of the joint.
*+/-Loose bodies in the joint ([[AKA]] ''joint mice'').
*+/-Loose bodies in the joint ([[AKA]] ''joint mice'').


Line 70: Line 74:
DDx:
DDx:
*[[Chondrosarcoma]].
*[[Chondrosarcoma]].
*[[Osteoarthritis]].


Images:
Images:
Line 79: Line 84:
<pre>
<pre>
LOOSE BODIES, RIGHT ELBOW, REMOVAL:
LOOSE BODIES, RIGHT ELBOW, REMOVAL:
- SYNOVIAL OSTEOCHONDROMATOSIS.
- FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.
</pre>
</pre>



Revision as of 16:00, 12 December 2012

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.

Hyaline cartilage

Microscopic

Features:[4]

  • 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:

Perichondrium

Microscopic

Features:

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

Images:

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%.[6]
  • Classically location: knee.[6]
    • 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:[6]

  • Hyaline cartilage +/- lobular surface.
    • +/-Lacunae with binucleate cells.
    • +/-Nuclear atypia - moderate to severe.[7]
  • +/-Synovial hyperplasia - ribbon like tissue with an epithelium that has eosinophilic cytoplasm.
  • Bone.

DDx:

Images:

Sign out

LOOSE BODIES, RIGHT ELBOW, REMOVAL:
- FRAGMENTS OF BONE WITH CARTILAGE AND SYNOVIAL TISSUE COMPATIBLE WITH LOOSE BODIES.

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

  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. Cormack, David H. (2001). Essential Histology (2nd ed.). Lippincott Williams & Wilkins. pp. 178. ISBN 978-0781716680.
  5. 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.
  6. 6.0 6.1 6.2 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.
  7. URL: http://www.webpathology.com/image.asp?n=3&Case=369. Accessed on: 10 December 2012.