Difference between revisions of "Chondroblastoma"

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#redirect [[Chondro-osseous tumours#Chondroblastoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Chondroblastoma_-_very_high_mag.jpg
| Width      =
| Caption    = Chondroblastoma. [[H&E stain]].
| Synonyms  =
| 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  =
| LMDDx      = [[giant cell tumour of bone]], [[chondroma]], well-differentiated [[chondrosarcoma]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = growth plate - see ''[[chondro-osseous tumours]]''
| Assdx      =
| Syndromes  =
| Clinicalhx = "young" - growth plates open
| Signs      =
| Symptoms  = painful
| Prevalence =
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Chondroblastoma''' is a benign [[chondro-osseous tumour]] that afflicts the young (growth plates open).
 
==General==
*Growth plate lesion.
*Sclerotic margin.
*"Young" = growth plates open. 
*Most common in teens.
*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==
*Well-defined lesion.
 
===Image===
*[http://www.flickr.com/photos/35441329@N05/4052875138/in/set-72157622681280610 Chondroblastoma (flickr.com/humpath)].
 
==Microscopic==
Features:<ref name=Ref_WMSP_642>{{Ref WMSP|642}}</ref>
*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:
**Nuclear morphology variable: ovoid, folded or grooved.
**Moderate-abundant eosinophilic cytoplasm.
*+/-Calcification surrounds the cell nests ("chickenwire" appearance) - '''classic feature'''.
**Cell nests have a thin pale blue rimming.
*+/-[[Giant cells]].
**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:
*[[Giant cell tumour of bone]].
*[[Chondroma]].
*Well-differentiated [[chondrosarcoma]].
*Chondromyxoid fibroma - also has 'immature cartilage'
*[[Aneurysmal bone cyst]] - dont forget that these may be secondary to another lesion.
 
===Images===
<gallery>
Image:Chondroblastoma_-_intermed_mag.jpg | Chondroblastoma - intermed. 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>
www:
*[http://img.medscape.com/pi/emed/ckb/orthopedic_surgery/1230552-1254949-996.jpg Chondroblastoma (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>
*Tumor Library - case with giant cells[http://www.tumorlibrary.com/case/image.jsp?title=Chondroblastoma+-+Distal+femur+-+Photomicrograph&uri=/case/images/3571.jpg]
 
==IHC==
Features:<ref name=Ref_WMSP_642>{{Ref WMSP|642}}</ref>
*S100 +ve.
*Vimentin +ve.<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>
 
==See also==
*[[Chondro-osseous tumours]].
*Tumor Library[http://www.tumorlibrary.com/case/list.jsp?order=diagnosis+ASC&diagnosis=Chondroblastoma]
 
==References==
{{Reflist|2}}
 
[[Category:Diagnosis]]
[[Category:Chondro-osseous tumours]]

Latest revision as of 05:24, 21 October 2014

Chondroblastoma
Diagnosis in short

Chondroblastoma. H&E stain.
LM 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
LM DDx giant cell tumour of bone, chondroma, well-differentiated chondrosarcoma
Site growth plate - see chondro-osseous tumours
Clinical history "young" - growth plates open
Symptoms painful
Prognosis benign

Chondroblastoma is a benign chondro-osseous tumour that afflicts the young (growth plates open).

General

  • Growth plate lesion.
  • Sclerotic margin.
  • "Young" = growth plates open.
  • Most common in teens.
  • Typically painful.[1]
  • Radiographic osteolytic lesion of the epiphysis [1]
  • Rare, 1 % of all bone tumors
  • Benign
  • Humerus, tibia, femur

Gross

  • Well-defined lesion.

Image

Microscopic

Features:[2]

  • 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:
    • Nuclear morphology variable: ovoid, folded or grooved.
    • Moderate-abundant eosinophilic cytoplasm.
  • +/-Calcification surrounds the cell nests ("chickenwire" appearance) - classic feature.
    • Cell nests have a thin pale blue rimming.
  • +/-Giant cells.

DDx:

Images

  • Chondroblastoma - intermed. mag. (WC)

  • Chondroblastoma - very high mag. (WC)

  • Chicken wire calcification. (SKB)

  • Chicken wire calcification. (SKB)

  • Immature cartilage surrounded by aneurysmal bone cyst with giant cells. (SKB)

  • Immature cartilage (left) abutting aneurysmal bone cyst (right) with giant cells. (SKB)

  • Immature cartilage. (SKB)

www:

IHC

Features:[2]

  • S100 +ve.
  • Vimentin +ve.[4]

See also

References

  1. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 625. ISBN 978-1416054542.
  2. ↑ 2.0 2.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 642. ISBN 978-0781765275.
  3. ↑ Sepah, YJ.; Umer, M.; Minhas, K.; Hafeez, K. (2007). "Chondroblastoma of the cuboid with an associated aneurysmal bone cyst: a case report.". J Med Case Rep 1: 135. doi:10.1186/1752-1947-1-135. PMID 17999776.
  4. ↑ 4.0 4.1 4.2 URL: http://emedicine.medscape.com/article/1254949-diagnosis. Accessed on: 31 December 2010.
  5. ↑ URL: http://path.upmc.edu/cases/case494.html. Accessed on: 24 January 2012.
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