Chondroblastoma

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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

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.