|
|
| Line 8: |
Line 8: |
|
| |
|
| ==Pathophysiology== | | ==Pathophysiology== |
| ===Gross Pathology===
| |
| Characteristic features of chondrosarcoma on gross pathology are:
| |
| *Greyish-white lobulated mass
| |
| *[[Necrosis]]
| |
| *[[Calcification]]
| |
| *Mucoid degeneration
| |
|
| |
| ===Microscopic Pathology===
| |
| In general chondrosarcomas are multilobulated (due to hyaline cartilage nodules) with central high water content and peripheral enchondral ossification. Characteristic features on microscopic analysis are variable depending on the chondrosarcoma subtype:<ref name="librepathology">librepathology.Chondrosarcoma.http://librepathology.org/wiki/index.php/Chondrosarcoma</ref>
| |
| ====Mesenchymal chondrosarcoma====
| |
| Mesenchymal chondrosarcoma is a [[malignant tumor]] with a characteristic biphasic pattern:
| |
| *Poorly differentiated small round blue cells.
| |
| *Islands of well-differentiated [[hyaline cartilage]].
| |
| **Progressive maturation of [[cartilage]] towards the center.
| |
| **Central [[calcification]] or bone formation.
| |
| *Can have a hemangiopericytomatous vascular pattern.
| |
| {| align
| |
| |-valign="top"
| |
| | [[Image:800px-Bone Chondrosarcoma Mesenchymal MP5 PA.JPG|thumb|350px|Islands of cartilage in a background of small blue cells]]
| |
| |}
| |
|
| |
| ====Myxoid chondrosarcoma====
| |
| *Myxoid background.
| |
| *small cells with eosinophilic cytoplasm.
| |
| {| align
| |
| |-valign="top"
| |
| | [[Image:790px-Bone Chondrosarcoma Myxoid MP2 PA.JPG|thumb|350px|Anastomizing chords of small neoplastic cells surround mucin pools]]
| |
| | [[Image:800px-Bone Chondrosarcoma Myxoid MP PA.JPG|thumb|350px|Chords of neoplastic cells surround mucin pools]]
| |
| |}
| |
| ====Clear cell chondrosarcoma====
| |
| *Lobules of uniform to polymorphic densely-packed large cells.
| |
| *Well defined pushing borders.
| |
| *Clear to intensively acidophilic granular 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.
| |
| {| align
| |
| |-valign="top"
| |
| | [[Image:800px-Bone Chondrosarcoma ClearCell HP PA.jpg|thumb|350px|High grade round cells with cytoplasmic clearing]]
| |
| | [[Image:800px-Bone Chondrosarcoma ClearCell MP PA.jpg|thumb|350px|The lesion also had areas of more conventional chondrosarcoma]]
| |
| |}
| |
| ====Dedifferentiated chondrosarcoma====
| |
| *Poorly differentiated (mesenchymal) malignancy.
| |
| *Well-differentiated cartilaginous component.
| |
|
| |
| ==Grading==
| |
| Physicians grade chondrosarcoma using several criteria. But, particularly based on how abnormal the cancerous cells appear under the microscope and the growth rate of the tumors themselves, both of which are directly linked to the propensity of the cancer to invade locally, and to spread widely to distant organs and sites in the body (called [[metastasis]]).
| |
|
| |
| ====Grade 1====
| |
| *Chondrosarcoma grows relatively slowly, has cells whose [[histological]] appearance is quite similar to cells of normal cartilage.
| |
| *Mostly chondroid matrix, little if any myxoid.
| |
| *Mild-to-moderate increase of cellularity +/- binucleated cells.
| |
| *Have much less aggressive invasive and metastatic properties.
| |
| {| align
| |
| |-valign="top"
| |
| | [[Image:800px-Bone Chondrosarcoma Grade1 HP2 PA.JPG|thumb|350px|Grade 1 - Somewhat cellular cartilage with binucleation]]
| |
| |}
| |
|
| |
| ====Grade 2====
| |
| *Intermediate grade chondrosarcoma.
| |
| *Little chondroid matrix, Necrosis and more common prominent myxoid.
| |
| {| align
| |
| |-valign="top"
| |
| | [[Image:800px-Bone Chondrosarcoma Grade2 HP PA.jpg|thumb|350px|Grade 2 - Very cellular cartilage with obvious hyperchromasia and nuclear atypia]]
| |
| |}
| |
| ====Grades 3====
| |
| *Grade 3 chondrosarcoma is increasingly faster-growing cancer, with more varied and abnormal-looking cells.
| |
| *Characterized by myxoid stroma, nuclear [[pleomorphism]] and [[mitoses]].
| |
| *Absent chondroid matrix.
| |
| *These are much more likely to infiltrate surrounding tissues, [[lymph nodes]], and organs.
| |
| {| align
| |
| |-valign="top"
| |
| | [[Image:800px-Bone Chondrosarcoma Grade3 HP PA.JPG|thumb|350px|Grade 3 - Even more cellular neoplastic cartilage with high grade nuclear atypia]]
| |
| |}
| |
|
| |
| ====Grade 4====
| |
| *Some, but not all, authorities and medical facilities assign a "Grade 4" to the most [[anaplastic]], undifferentiated cartilage-derived tumors.
| |
|
| |
|
| |
|
| ==References== | | ==References== |