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Difference between revisions of "Chondrosarcoma"
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| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Chondrosarcoma_(3).jpg | | Image = Chondrosarcoma_(3).jpg | ||
| Width = | | Width = | ||
| Caption = Chondrosarcoma. [[H&E stain]]. | | Caption = Chondrosarcoma. [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
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Image:Chondrosarcoma_(2).jpg | Chondrosarcoma - high mag. (WC) | Image:Chondrosarcoma_(2).jpg | Chondrosarcoma - high mag. (WC) | ||
Image:Chondrosarcoma_(3).jpg | Chondrosarcoma - high mag. (WC) | Image:Chondrosarcoma_(3).jpg | Chondrosarcoma - high mag. (WC) | ||
Image:Bone Chondrosarcoma Grade2 MP PA.jpg|Grade 2 chondrosarcoma, low power showing bone permeation (SKB) | |||
Image:Bone Chondrosarcoma Grade2 HP PA copy.jpg|Chondrocytic hyperchromasia and atypicality in this photo of a Grade 2 chondrosarcoma. (SKB) | Image:Bone Chondrosarcoma Grade2 HP PA copy.jpg|Chondrocytic hyperchromasia and atypicality in this photo of a Grade 2 chondrosarcoma. (SKB) | ||
Image:Bone Chondrosarcoma Grade2 MP3 PA.JPG|Lobule of neoplastic cartilage with some bone permeation and calcification at the top of the photo.(SKB) | Image:Bone Chondrosarcoma Grade2 MP3 PA.JPG|Lobule of neoplastic Grade 2 cartilage with some bone permeation and calcification at the top of the photo.(SKB) | ||
Image:Bone Chondrosarcoma Grade2 HP.JPG|Lobule of neoplastic cartilage with atypia and bone permeation. (SKB) | Image:Bone Chondrosarcoma Grade2 HP.JPG|Lobule of neoplastic Grade 2 cartilage with atypia and bone permeation. (SKB) | ||
Image:Bone Chondrosarcoma Grade3 MP PA.JPG|Grade 3 - very cellular neoplastic cartilage with high grade nuclear atypia. (SKB) | |||
</gallery> | </gallery> | ||
www: | www: | ||
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*[[Parachordoma]].<ref name=pmid10809219>{{cite journal |author=Fisher C |title=Parachordoma exists--but what is it? |journal=Adv Anat Pathol |volume=7 |issue=3 |pages=141–8 |year=2000 |month=May |pmid=10809219 |doi= |url=}}</ref> | *[[Parachordoma]].<ref name=pmid10809219>{{cite journal |author=Fisher C |title=Parachordoma exists--but what is it? |journal=Adv Anat Pathol |volume=7 |issue=3 |pages=141–8 |year=2000 |month=May |pmid=10809219 |doi= |url=}}</ref> | ||
*[[Chordoma]]. (???) | *[[Chordoma]]. (???) | ||
*Myxoid liposarcoma. | |||
*Metastatic myxoid carcinoma. | |||
Images: | Images: | ||
<gallery> | <gallery> | ||
Image:Bone Chondrosarcoma Myxoid MP2 PA.JPG|Anastomizing chords of small neoplastic cells surround mucin pools.(SKB)</gallery> | Image:Bone Chondrosarcoma Myxoid MP2 PA.JPG|Anastomizing chords of small neoplastic cells surround mucin pools.(SKB) | ||
Image:Bone Chondrosarcoma Myxoid MP PA.JPG|Chords of neoplastic cells surround mucin pools. (SKB)</gallery> | |||
*Pathology outlines [http://pathologyoutlines.com/wick/softtissue/chondrosarcomaextraskeletalmyxoidtypemicro1.jpg] | *Pathology outlines [http://pathologyoutlines.com/wick/softtissue/chondrosarcomaextraskeletalmyxoidtypemicro1.jpg] | ||
*Pathology outlines [http://pathologyoutlines.com/wick/softtissue/chondrosarcomaextraskeletalmyxoidtypemicro2.jpg] | *Pathology outlines [http://pathologyoutlines.com/wick/softtissue/chondrosarcomaextraskeletalmyxoidtypemicro2.jpg] | ||
====Clear cell chondrosarcoma==== | |||
*Rare variant of chondrosarcoma (1.6%–5.4% of all chondrosarcomas) | |||
*Usually a low-grade malignant tumour<ref>{{Cite journal | last1 = Corradi | first1 = D. | last2 = Bacchini | first2 = P. | last3 = Campanini | first3 = N. | last4 = Bertoni | first4 = F. | title = Aggressive clear cell chondrosarcomas: do distinctive characteristics exist?: a report of 4 cases. | journal = Arch Pathol Lab Med | volume = 130 | issue = 11 | pages = 1673-9 | month = Nov | year = 2006 | doi = 10.1043/1543-2165(2006)130[1673:ACCCDD]2.0.CO;2 | PMID = 17076530 }}</ref> | |||
*Younger age than conventional chondrosarcoma | |||
*Teens to 40s; more common in males | |||
*Epiphyses of long tubular bones; proximal femur or humerus | |||
*Rarely head and neck <ref>{{Cite journal | last1 = Mokhtari | first1 = S. | last2 = Mirafsharieh | first2 = A. | title = Clear cell chondrosarcoma of the head and neck. | journal = Head Neck Oncol | volume = 4 | issue = | pages = 13 | month = | year = 2012 | doi = 10.1186/1758-3284-4-13 | PMID = 22520362 }}</ref> | |||
*Malignant counterpart of chondroblastoma? | |||
Microscopic findings | |||
*Lobules of uniform to polymorphic densely-packed large cells | |||
*Well defined pushing borders | |||
*Clear to intensively acidophilic granular cytoplasm cytoplasm with vacuoles | |||
*Central nuclei with occasional prominent nucleoli | |||
*Low mitotic rate | |||
*Clear cell areas lack production of hyaline chondroid matrix | |||
*Areas with osteoclast-type giant cells mixed with small trabeculae of reactive bone | |||
*May contain conventional low-grade chondrosarcoma | |||
*May have secondary aneurysmal bone cyst changes | |||
<gallery> | |||
Image:Bone Chondrosarcoma ClearCell HP PA.jpg|High grade round cells with cytoplasmic clearing. (SKB) | |||
Image:Bone Chondrosarcoma ClearCell MP3 PA.jpg|High grade round cells with cytoplasmic clearing. (SKB) | |||
Image:Bone Chondrosarcoma ClearCell MP4 PA.jpg|Clear cells, giant cells and bone spicules. (SKB) | |||
Image:Bone Chondrosarcoma ClearCell MP2 PA.jpg|Somewhat hemangiopericytomatous vascular pattern with giant cells. (SKB) | |||
Image:Bone Chondrosarcoma ClearCell MP4 PA.jpg|Clear cells, giant cells and bone spicules. (SKB) | |||
Image:Bone Chondrosarcoma ClearCell MP PA.jpg|The lesion also had areas of more conventional chondrosarcoma. (SKB) | |||
</gallery> | |||
*Pathology outlines [http://pathologyoutlines.com/wick/chondrosarcoma%20clear%20cell%20type%20micro7.jpg] | |||
*Pathology outlines [http://pathologyoutlines.com/wick/chondrosarcoma%20clear%20cell%20type%20micro8.jpg] | |||
*Pathology outlines [http://pathologyoutlines.com/wick/chondrosarcoma%20clear%20cell%20type%20micro2.jpg] | |||
*Tumor library [http://www.tumorlibrary.com/case/images/1521.jpg] | |||
*Tumor library [http://www.tumorlibrary.com/case/images/1522.jpg] | |||
DDX: | |||
*Chondroblastoma | |||
*Giant cell tumour of bone | |||
*Osteoblastic tumours | |||
*Metastatic clear cell renal cell carcinoma | |||
Outside sources: | |||
E-immunohistochemistry[http://e-immunohistochemistry.info/web/Clear_cell_chondrosarcoma.htm] | |||
====Extraskeletal myxoid chondrosarcoma==== | ====Extraskeletal myxoid chondrosarcoma==== | ||
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Image: | Image: | ||
*[http://www.cttr.org/large/03113.jpg Extraskeletal myxoid chondrosarcoma (cttr.org)].<ref>URL: [http://www.cttr.org/cms/?p=736 http://www.cttr.org/cms/?p=736]. Accessed on: 1 May 2011.</ref> | *[http://www.cttr.org/large/03113.jpg Extraskeletal myxoid chondrosarcoma (cttr.org)].<ref>URL: [http://www.cttr.org/cms/?p=736 http://www.cttr.org/cms/?p=736]. Accessed on: 1 May 2011.</ref> | ||
<gallery> | |||
Image:SoftTissue ExtraskeletalMyxoidChondrosarcoma MP CTR.jpg|Strands of atypical cells suspended in mucin. (SKB) | |||
Image:SoftTissue ExtraskeletalMyxoidChondrosarcoma HP CTR.jpg|Strands of atypical cells suspended in mucin. (SKB) | |||
</gallery> | |||
====Dedifferentiated chondrosarcoma==== | ====Dedifferentiated chondrosarcoma==== | ||
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<gallery> | <gallery> | ||
Image:Bone Chondrosarcoma Dedifferentiated PA copy.jpg|A lobule of cartilagenous chondrosarcoma on the left; high grade sarcoma on the right. (SKB) | Image:Bone Chondrosarcoma Dedifferentiated PA copy.jpg|A lobule of cartilagenous chondrosarcoma on the left; high grade sarcoma on the right. (SKB) | ||
Image:Bone Chondrosarcoma Dedifferentiated HP PA.jpg|High grade sarcoma on the left and upper; malignant cartilage right and lower. (SKB) | |||
</gallery> | </gallery> | ||
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*Grade II: between Grade I and Grade III. | *Grade II: between Grade I and Grade III. | ||
*Grade III: nuclear pleomorphism, mitoses common. | *Grade III: nuclear pleomorphism, mitoses common. | ||
<gallery> | |||
Image:Bone Chondrosarcoma Grade1 HP2 PA.JPG|Grade 1 - Somewhat cellular cartilage with binucleation.(SKB) | |||
Image:Bone Chondrosarcoma Grade2 HP PA.jpg|Grade 2 - Very cellular cartilage with obvious hyperchromasia and nuclear atypia. (SKB) | |||
Image:Bone Chondrosarcoma Grade3 HP PA.JPG|Grade 3 - Even more cellular neoplastic cartilage with high grade nuclear atypia. (SKB) </gallery> | |||
==IHC== | ==IHC== | ||
*S-100 | *S-100 positive | ||
*Keratin negative | |||
*Collagen II positive | |||
==See also== | ==See also== | ||