Revision as of 02:26, 29 November 2013

Chondro-osseous tumours occasionally cross the desk of the pathologist. They are grouped together as bone may develop from cartilage.

Primary bone tumours are rare; the most common bone tumour is metastases.^[1]

Bone tumours occasionally are lumped with soft tissue tumours. Soft tissue tumours are dealt with in the soft tissue lesions article. An introduction to bone is found in the bone article. An introduction to cartilage is found in the cartilage article.

General

Diagnosis of a primary bone tumour should not be made without radiologic & clinical information!
Metastasis:primary bone tumours = >20:1.^[1]

Common malignant

Osteosarcoma.
Chondrosarcoma.
Ewing's sarcoma.
Multiple myeloma.
Metastases.
- Most common tumours metastatic to bone (mnemonic: BLT with Ketchup & Pickles):
  - Breast.
  - Liver.
  - Thyroid gland.
  - Kidney.
  - Prostate gland.

Epidemiology:^[2]

Osteosarcoma -> 2nd decade.
Ewing's ->5-20 yrs.
Chondrosarcoma -> from enchondroma or osteochrondroma -- patients over 40 yrs.
Multiple myeloma -> most common primary bone tumour in adults.

Malignant bone tumours by age

Most common by age:^[2]

<1 year old - neuroblastoma.
1-10 years old - Ewing's of tubular bones.
10-30 years old - osteosarcoma, Ewing's of flat bones.
30-40 years old - reticulum cell sarcoma, fibrosarcoma, parosteal osteosarcoma, malignant giant cell tumour, lymphoma.
>40 years old - mets, multiple myeloma, chondrosarcoma.

Benign aggressive bone tumours

Giant cell tumour of bone.
Osteoblastoma.
- Thought to be related to osteoid osteoma.
- If in long bones often diaphyseal.

Ref.:^[3]^[4]

Summary tables

Bone tumours

Entity	Key feature	Other features	Radiology / gross	Clinical	Stains / other	Image
Osteoma	normal bone (???)	other features (???)	radiology / gross (???)	?	no stains / may be assoc. with FAP	Image (???)
Osteoid osteoma	osteoblastic rimming	anastomosing bony trabeculae	<= 1.5 cm, metaphysis	painful, NSAIDs remove pain, young	IHC / other	Osteoid osteoma. (WC)
Osteoblastoma	osteoblastic rimming	anastomosing bony trabeculae	> 1.5 cm, metaphysis	not painful	IHC / other	Osteoblastoma. (WC)
Ewing sarcoma	small round blue cell tumour	cytoplasmic clearing (due to glycogen)	usu. diaphysis	pediatric, typically 1-10 years	PAS+, PASD-, chromosomal translocations (usually t(11;22)(q24;q12))	Ewing sarcoma. PAS stain. (WC)
Osteosarcoma	osteoid	+/-hemorrhage, +/-cartilage	distal femur, prox. tibia, prox. humerous	typically 10-30 years, pain, swelling	no stains; many subtypes	Osteosarcoma. (WC)
Giant cell tumour of bone	abundant giant cells	nuclei of surrounding cells similar to those in giant cells	growth plate of long bones	20-45 years old, +/-joint pain, +/-immobility	IHC / other	Giant cell tumour. (WC)

Cartilage tumours

Entity	Key feature	Other features	Radiology / gross	Clinical	Stains / other	Image
Chondroma	ctyologically benign cells	equally spaced nests	usu. diaphysis	benign / DDx: chondroma, well-diff. chondrosarcoma	IHC / bone marrow cavity chondroma = enchondroma	Enchondroma. (WC)
Chondroblastoma	abundant extracellular material, abundant eosinophilic cytoplasm	calcifications surround cells nests ("chickenwire" appearance) - classic	epiphysis	DDx: giant cell tumour of bone	S100+ve, vimentin +ve	Chondroblastoma. (WC)
Chondrosarcoma	cartilaginous appearance +/- nuclear atypia	lack osteoid, if present -> osteosarcoma	usu. diaphysis, classically hip; almost never distal extremity	>40 years old	IHC / may be histologically benign looking	Chondrosarcoma. (WC)

Other

Entity	Key feature	Other features	Radiology / gross	Clinical	Stains / other	Image
Osteochondroma	benign bone and cartilage	Other features	metaphyseal lesions	Clinical	IHC / other	Image
Adamantinoma	bisphasic - stroma & epithelium	Other features	tibia, fibula, intracortical, radiolucent	Clinical	IHC / other	Adamantinoma. (WC)
Diffuse tenosynovial giant-cell tumour (AKA PVNS)	pigmented giant cells	nodules	Radiology / gross	Clinical	IHC / other	PVNS. (WC)
Brown tumour	fibrosis, +/-giant cells	unaffected bone incr. osteoblasts and osteoclasts	Radiology / gross	due to hypercalcemia; not a neoplasm	IHC / other	Brown tumour. (WC)

Radiology

Radiologic features

Features	Benign	Malignant
Bone changes	sclerotic rim	tumour perforation
Circumscription	pushing margins	ill-defined/moth-eaten
Soft tissue involvement	no	common
Periosteal reaction	no	"hair-on-end" or "sunburst", "onion skin", Codman's triangle

Location

Diagnosis	Epiphysis	Metaphysis	Diaphysis	Type of lesion
Aneurysmal bone cyst	common	most common	rare	bone
Chondroblastoma	most common	rare	extremely rare	cartilage
Chondrosarcoma	uncommon	common	most common	cartilage
Chondromyxoid fibroma	rare	most common	common	other
Enchondroma	rare	common	common	cartilage
Ewing sarcoma	rare	common	most common	bone
Giant cell tumour	most common	rare	extremely rare	bone
Metastatic carcinoma	rare	common	most common	other
Non-ossifying fibroma	extremely rare	most common	common	other
Osteoblastoma	rare	most common	uncommon	bone
Osteochondroma	extremely rare^{[citation needed]}	most common	common	bone/cartilage
Osteoid osteoma	uncommon	common	common^[5]	bone
Osteosarcoma	rare	most common	uncommon	bone

How to remember the primary bone lesions:

Ewing sarcoma is the only malignant primary bone tumour of the diaphysis.
Giant cell tumour of bone is the only primary bone lesion of the epiphysis.
The rest of the primary bone lesions are metaphyseal.
- Osteochondroma is bone first and cartilage second. It behaves like most primary bone lesions; it is usually metaphyseal.

How to remember the primary cartilaginous lesions:

Chondroblastoma is epiphyseal. The chicken wire goes around the chicken coop.
The others are diaphyseal.

Cartilage

Chondroma

General

Benign thingy.
Usual legs and feet.
May be difficult to separate from chondrosarcoma.
Multiple chondromas = enchondromatosis; three distinct syndromes:^[6]
- Ollier disease.
- Maffucci syndrome - with hemangiomas, increased risk of chondrosarcoma.^[7]
- Metachondromatosis - autosomal dominant.
Enchondroma = chondroma in the marrow space.

Clinical:^[6]

Pain.

Radiology

Features:^[6]

Lytic lesion.
Usual close to a growth plate.

Microscopic

Features:

Ctyologically benign cells is spaced nests.

Images

Enchondroma - intermed mag. (WC)
Enchondroma - very high mag. (WC)

Chondroblastoma

General

Growth plate lesion.
Sclerotic margin.
"Young" = growth plates open.
Typically painful.^[8]

Gross

Well-defined lesion.

Image:

Chondroblastoma (flickr.com/humpath).

Microscopic

Features:^[9]

Abundant extracellular material - pink on H&E stain - looks vaguely like 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.

DDx:

Images

Chondroblastoma - intermed. mag. (WC)
Chondroblastoma - very high mag. (WC)

www:

IHC

Features:^[9]

S100 +ve.
Vimentin +ve.^[10]

Chondromyxoid fibroma

General

Benign.
Teenagers or young adults.

Gross

Metaphyseal lesion.
Well-circumscribed.

Microscopic

Features:^[12]

Spindle cells or stellate cells in a myxoid or chondroid stroma.

Images:

Chondrosarcoma

General

Usually a good prognosis.

Clinical/epidemiologic features:^[13]

Usually arise in a (benign) abnormality of cartilage (e.g. osteochondroma, enchondroma).
May be associated with a syndrome:
- Olier disease (multiple enchondromatosis).
- Maffucci syndrome (multiple enchondromas and hemangiomas).

Notes:

Review article (from oncology perspective): PMID 17545802.

Subtypes

Several subtypes exist:

Chondrosarcoma not otherwise specified (NOS).
Juxtacortical chondrosarcoma.
Myxoid chondrosarcoma.
Mesenchymal chondrosarcoma.
Clear cell chondrosarcoma.
Dedifferentiated chondrosarcoma.

Microscopic

Features:^[14]^[15]

"Abnormal cartilage":
- +/-Nuclear atypia - high grade lesions.
  - High grade lesions:
    - Nuclear clearing.
    - Nucleoli.
    - Hyperchromasia.
  - Low/intermediate grade lesions:
    - Bi-nucleation.
    - Hypochromatic enlarged nuclei.
    - Infiltration of lamellar bone ("invasion") - not common - diagnostic.
- Increased cellularity.
  - More cellular than cartilage... but relatively paucicellular compared to other sarcomas.
- Irregular spacing of chondrocytes.

Notes:

Low grade chondrosarcoma are not cytologically malignant; the diagnosis rests mostly on radiologic findings.
- The exception is infiltration of lamellar bone -- this is diagnostic of chondrosarcoma.^[16]

DDx:

Chordoma.
Enchondroma.
Synovial chondromatosis.
Osteosarcoma - esp. chondroblastic osteosarcoma - has osteoid, may be focal.

Images

Chondrosarcoma - low mag. (WC)
Chondrosarcoma - high mag. (WC)
Chondrosarcoma - high mag. (WC)

www:
- Chondrosarcoma (upmc.edu).

Variants

Mesenchymal chondrosarcoma

Arise in soft tissue; this is where the name comes from.^[17]
Rare variant of chondrosarcoma.

Microscopic: Features:

"White clouds in a blue sky".

Image:

Mesenchymal chondrosarcoma (ouhsc.edu).

Myxoid chondrosarcoma

Microscopic: Features:

Chordoma-like:
- Myxoid background.
- Small cells with eosinophilic cytoplasm.

DDx:

Chondroid syringoma.
Parachordoma.^[18]
Chordoma. (???)

Extraskeletal myxoid chondrosarcoma

Originally thought to be a variant of myxoid chondrosarcoma of bone; however, may not be a chondrosarcoma at all.^[19]
Characteristic chromosomal translocation: t(9;22) CHN-EWS.

DDx:

Chordoma.^[19]
- S-100 +ve (strong).
- EMA +ve.

Image:

Extraskeletal myxoid chondrosarcoma (cttr.org).^[20]

Dedifferentiated chondrosarcoma

Clinical:

Abysmal to poor prognosis.
- In one series (22 patients) 5-year survival ~20%.^[21]
- All dead in two years in another series (25 patients).^[22]

Features:^[22]

Poorly differentiated (mesenchymal) malignancy.
Well-differentiated cartilaginous component.

Images:

Dedifferentiated chondrosarcoma (upmc.edu).

Grading

Features:^[23]

Grade I: mild-to-moderate increase of cellularity +/- binucleated cells.
Grade II: between Grade I and Grade III.
Grade III: nuclear pleomorphism, mitoses common.

IHC

S-100 -ve. (???)

Bone

Osteoma

General

Benign.
May be associated with familial adenomatous polyposis.
Normal bone - unusual location/outgrowth.

Microscopic

Features:

Normal bone.

Osteoid osteoma

Main article: Osteoid osteoma

Osteoblastoma

Main article: Osteoblastoma

Ewing sarcoma

Main article: Ewing sarcoma

Osteosarcoma

Main article: Osteosarcoma

Giant cell tumour of bone

Main article: Giant cell tumour of bone

Other

This section collects stuff that doesn't neatly fit into the bone or cartilage category.

Osteochondroma

General

Benign.
Very common.
Abnormal outgrowth of bone and cartilage - associated with growth plate.
Usually present before age 20.^[24]

Gross

Features:

Metasphyseal lesions.^[25]
- Often distal femur, proximal humerus or proximal tibia.^[24]
- Occasionally iliac mass.^[26]
Mushroom-like shape - with broad or narrow base.

Note:

Very unusual in craniofacial bones.^[24]

Microscopic

Features:^[24]

Bone - forms base of "mushroom".
Cartilage - layer usu. thinner in older individuals.
- Lobular arrangement^[27] - clusters of 3-12 lacunae (separated by stroma).
- May have mild atypia.
- Nuclear enlargement - up to 5x normal.
Perichondrium - covers the cartilage.
- Thin layer of cells - higher cellular density than cartilage.
  - Bland spindle cells in a fibrous (eosinophilic) stroma.

Notes:

Benign cartilage - one chondrocyte per lacuna, small and round nucleus, no binucleation.

DDx:

Chondrosarcoma - esp. in older individuals.

Images:

Super rare intracranial mesenchymal osteochondroma - several images (upmc.edu).^[27]

Diffuse tenosynovial giant-cell tumour

AKA tenosynovial giant-cell tumour, diffuse type.
Previously known as pigmented villonodular synovitis (PVNS).^[28]

General

Course: benign.
- Occasionally malignant.^[29]^[30]^[31]
Giant cell tumour of the tendon sheath is considered to be the soft-tissue counterpart of PVNS.^[32]

Gross

Typically knee or hip.^[33]
May be extra-articular.^[31]

Microscopic

Features:^[34]

Subsynovial nodules composed of cells with:
- Abundant cytoplasm.
- Pale nuclei.
Multinucleated giant cells.
Hemosiderin-laden macrophages.
Foam cells.

DDx - general for the site:^[35]

Images

PVNS - low mag. (WC)
PVNS - high mag. (WC)

www:

Molecular

Clonal.^[36]

Sign out

RIGHT FEMORAL HEAD AND JOINT CAPSULE, EXCISION:
- DEGENERATIVE JOINT DISEASE.
- DIFFUSE TENOSYNOVIAL GIANT-CELL TUMOUR (PIGMENTED VILLONODULAR SYNOVITIS).

Micro

The soft tissue sections show nodules with abundant hemosiderin-laden macrophages and multinucleated giant cells. Nuclear atypia is not identified. Mitotic activity is not apparent.

Giant cell tumour of tendon sheath

Abbreviated GCT of tendon sheath.

General

Can be thought of as the small joint version of diffuse tenosynovial giant-cell tumour (AKA PVNS).^[37]
Rarely recur.
Classically afflicts the hand.^[38]
Rarely malignant.^[39]^[40]

Gross

Features:^[38]

Circumscribed mass - yellow-brown to tan.

Note:

May be associated with bony erosions in larger lesions.^[38]

Image:

GCT of tendon sheath (nih.gov).^[41]

Microscopic

Features:^[37]

Foam cells.
- Cells with moderate to abundant foamy-appearing cytoplasm.
Multinucleated giant cells - may be scarce.
+/-Tendon.
- Dense connective tissue.
+/-Hemosiderin-laden macrophages.

Note:

Features of malignancy: nuclear pleomorphism,^[40] abnormal mitoses, >10 mitoses/HPF, tumour necrosis lack of maturation to superficial part (nuclei shrink, cytoplasm lipid-ified).^[37]

DDx:

Giant cell lesions.

Images

GCT of tendon sheath. (WC/KGH)

www:

Sign out

LESION, RIGHT INDEX FINGER, EXCISION:
- GIANT CELL TUMOUR OF THE TENDON SHEATH.

Micro

The sections show histiocytes and rare multinucleated giant cells on a background of dense connective tissue compatible with tendon. No nuclear atypia is apparent. Rare mitotic activity is identified. No atypical mitoses are apparent.

Alternate

The sections show histiocytes and rare multinucleated giant cells on a background of dense connective tissue compatible with tendon. Hemosiderin-laden macrophages are present. No nuclear atypia is apparent. No mitotic activity is apparent.

Adamantinoma

Main article: Adamantinoma

Brown tumour

General

Not a true neoplasm.^[42]
- If tumour is understood as a synonym for neoplasm, the name is a misnomer.
- May (clinically) mimic a true neoplasm.
Due to hyperparathyroidism - usually parathyroid adenoma.
- Usually secondary to chronic renal failure.

Hypercalcemia DDx

Mnemonic GRIMED:^[43]

Granulomatous disease (tuberculosis, sarcoidosis).
Renal disease.
Immobility.
Malignancy (esp. squamous cell carcinoma, plasmacytoma).
Endocrine (primary hyperparathyroidism - leads to brown tumour).
Drugs (thiazides ... others).

Microscopic

Features:

Fibrosis.
+/-Giant cells with round to oval nuclei and nucleoli.^[44]
Bone unaffected by tumour - increased numbers of the following:
- Multinucleated cells (osteoclasts).
- Mononuclear cells around the bony trabeculae (osteoblasts).

DDx:

Giant cell tumour of bone and other giant cell lesions.

Images

Brown tumour - low mag. (WC)
Brown tumour - intermed. mag. (WC)
Brown tumour - high mag. (WC)

www:

References

↑ ^1.0 ^1.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 632. ISBN 978-0781765275.
↑ ^2.0 ^2.1 Yeung, J.C.; Leonard, Blair J. N. (2005). The Toronto Notes 2005 - Review for the MCCQE and Comprehensive Medical Reference (2005 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. OR42. ISBN 978-0968592854.
↑ Yeung, J.C.; Leonard, Blair J. N. (2005). The Toronto Notes 2005 - Review for the MCCQE and Comprehensive Medical Reference (2005 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. OR41. ISBN 978-0968592854.
↑ URL: http://www.emedicine.com/RADIO/topic494.htm.
↑ URL: http://www.wheelessonline.com/ortho/osteoid_osteoma. Accessed on: 7 May 2012
↑ ^6.0 ^6.1 ^6.2 URL: http://emedicine.medscape.com/article/389224-overview. Accessed on: 25 December 2010.
↑ Online 'Mendelian Inheritance in Man' (OMIM) 166000
↑ 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.
↑ ^9.0 ^9.1 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.
↑ ^10.0 ^10.1 ^10.2 URL: http://emedicine.medscape.com/article/1254949-diagnosis. Accessed on: 31 December 2010.
↑ URL: http://path.upmc.edu/cases/case494.html. Accessed on: 24 January 2012.
↑ 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.
↑ Skubitz KM, D'Adamo DR (November 2007). "Sarcoma". Mayo Clin. Proc. 82 (11): 1409–32. PMID 17976362. http://www.mayoclinicproceedings.com/content/82/11/1409.long.
↑ IAV. 26 February 2009.
↑ Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 417. ISBN 978-1416002741.
↑ Dickson, B. 28 April 2011.
↑ Dowling EA (June 1964). "Mesenchymal chondrosarcoma". J Bone Joint Surg Am 46: 747–54. PMID 14161087. http://www.ejbjs.org/cgi/reprint/46/4/747.pdf.
↑ Fisher C (May 2000). "Parachordoma exists--but what is it?". Adv Anat Pathol 7 (3): 141–8. PMID 10809219.
↑ ^19.0 ^19.1 Aigner, T.; Oliveira, AM.; Nascimento, AG. (Feb 2004). "Extraskeletal myxoid chondrosarcomas do not show a chondrocytic phenotype.". Mod Pathol 17 (2): 214-21. doi:10.1038/modpathol.3800036. PMID 14657948.
↑ URL: http://www.cttr.org/cms/?p=736. Accessed on: 1 May 2011.
↑ Mitchell, AD.; Ayoub, K.; Mangham, DC.; Grimer, RJ.; Carter, SR.; Tillman, RM. (Jan 2000). "Experience in the treatment of dedifferentiated chondrosarcoma.". J Bone Joint Surg Br 82 (1): 55-61. PMID 10697315.
↑ ^22.0 ^22.1 Sopta, J.; Dordević, A.; Tulić, G.; Mijucić, V. (Feb 2008). "Dedifferentiated chondrosarcoma: our clinico-pathological experience and dilemmas in 25 cases.". J Cancer Res Clin Oncol 134 (2): 147-52. doi:10.1007/s00432-007-0262-5. PMID 17653766.
↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 643. ISBN 978-0781765275.
↑ ^24.0 ^24.1 ^24.2 ^24.3 Parkin, B.; Bennett, JC.; Zaher, A. (Aug 2003). "Pathologic quiz case: an iliac mass in a 25-year-old woman. Osteochondroma.". Arch Pathol Lab Med 127 (8): e355-6. doi:10.1043/1543-2165(2003)127e355:PQCAIM2.0.CO;2. PMID 12873205.
↑ URL: http://www.medpath.info/MainContent/Skeletal/Bone_07.html. Accessed on: 18 September 2012.
↑ Kokavec, M.; Gajdoš, M.; Džupa, V. (2011). "[Osteochondroma of the iliac crest: case report].". Acta Chir Orthop Traumatol Cech 78 (6): 583-5. PMID 22217414.
↑ ^27.0 ^27.1 URL: http://path.upmc.edu/cases/case341/dx.html. Accessed on: 19 September 2012.
↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1247. ISBN 978-1416031215.
↑ Kondo, R.; Akiba, J.; Hiraoka, K.; Hisaoka, M.; Hashimoto, H.; Kage, M.; Yano, H. (Aug 2012). "Malignant diffuse-type tenosynovial giant cell tumor of the buttock.". Pathol Int 62 (8): 559-64. doi:10.1111/j.1440-1827.2012.02838.x. PMID 22827766.
↑ Li, CF.; Wang, JW.; Huang, WW.; Hou, CC.; Chou, SC.; Eng, HL.; Lin, CN.; Yu, SC. et al. (Apr 2008). "Malignant diffuse-type tenosynovial giant cell tumors: a series of 7 cases comparing with 24 benign lesions with review of the literature.". Am J Surg Pathol 32 (4): 587-99. doi:10.1097/PAS.0b013e318158428f. PMID 18301053.
↑ ^31.0 ^31.1 Somerhausen, NS.; Fletcher, CD. (Apr 2000). "Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease.". Am J Surg Pathol 24 (4): 479-92. PMID 10757395.
↑ URL: http://emedicine.medscape.com/article/1253223-overview. Accessed on: 6 January 2011.
↑ Frassica, FJ.; Bhimani, MA.; McCarthy, EF.; Wenz, J. (Oct 1999). "Pigmented villonodular synovitis of the hip and knee.". Am Fam Physician 60 (5): 1404-10; discussion 1415. PMID 10524485.
↑ URL: http://www.wheelessonline.com/ortho/pigmented_villonodular_synovitis.
↑ Krenn, V.; Morawietz, L.; König, A.; Haeupl, T. (Nov 2006). "[Differential diagnosis of chronic synovitis].". Pathologe 27 (6): 402-8. doi:10.1007/s00292-006-0866-6. PMID 17031677.
↑ Lucas, DR. (Aug 2012). "Tenosynovial giant cell tumor: case report and review.". Arch Pathol Lab Med 136 (8): 901-6. doi:10.5858/arpa.2012-0165-CR. PMID 22849738.
↑ ^37.0 ^37.1 ^37.2 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 341. ISBN 978-0470519035. Cite error: Invalid <ref> tag; name "Ref_DCHH341" defined multiple times with different content Cite error: Invalid <ref> tag; name "Ref_DCHH341" defined multiple times with different content
↑ ^38.0 ^38.1 ^38.2 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 612. ISBN 978-0781765275.
↑ Pan, YW.; Huang, XY.; You, JF.; Tian, GL.; Li, C. (Nov 2008). "[Malignant giant cell tumor of the tendon sheaths in the hand].". Zhonghua Wai Ke Za Zhi 46 (21): 1645-8. PMID 19094761.
↑ ^40.0 ^40.1 Shinjo, K.; Miyake, N.; Takahashi, Y. (Oct 1993). "Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature.". Jpn J Clin Oncol 23 (5): 317-24. PMID 8230758.
↑ Suresh, SS.; Zaki, H. (Dec 2010). "Giant cell tumor of tendon sheath: case series and review of literature.". J Hand Microsurg 2 (2): 67-71. doi:10.1007/s12593-010-0020-9. PMID 22282671.
↑ Meydan N, Barutca S, Guney E, et al. (June 2006). "Brown tumors mimicking bone metastases". J Natl Med Assoc 98 (6): 950–3. PMC 2569361. PMID 16775919. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569361/?page=1.
↑ Shiau, Carolyn; Toren, Andrew (2006). Toronto Notes 2006: Comprehensive Medical Reference (Review for MCCQE 1 and USMLE Step 2) (22nd edition (2006) ed.). Toronto Notes for Medical Students, Inc.. pp. Emerg.. ISBN 978-0968592861.
↑ URL: http://path.upmc.edu/cases/case139/micro.html. Accessed on: 6 January 2012.

External links

[Ref_WMSP632-1] 1.0 ^1.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 632. ISBN 978-0781765275.

[Ref_TN2005_OR42-2] 2.0 ^2.1 Yeung, J.C.; Leonard, Blair J. N. (2005). The Toronto Notes 2005 - Review for the MCCQE and Comprehensive Medical Reference (2005 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. OR42. ISBN 978-0968592854.

[Ref_TN2005_OR41-3] Yeung, J.C.; Leonard, Blair J. N. (2005). The Toronto Notes 2005 - Review for the MCCQE and Comprehensive Medical Reference (2005 ed.). The Toronto Notes Inc. for Medical Students Inc.. pp. OR41. ISBN 978-0968592854.

[4] URL: http://www.emedicine.com/RADIO/topic494.htm.

[wheelessonline-5] URL: http://www.wheelessonline.com/ortho/osteoid_osteoma. Accessed on: 7 May 2012

[emed_enchondroma-6] 6.0 ^6.1 ^6.2 URL: http://emedicine.medscape.com/article/389224-overview. Accessed on: 25 December 2010.

[omim166000-7] Online 'Mendelian Inheritance in Man' (OMIM) 166000

[Ref_PCPBoD8_625-8] 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.

[Ref_WMSP_642-9] 9.0 ^9.1 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.

[emed_chondroblastoma-10] 10.0 ^10.1 ^10.2 URL: http://emedicine.medscape.com/article/1254949-diagnosis. Accessed on: 31 December 2010.

[11] URL: http://path.upmc.edu/cases/case494.html. Accessed on: 24 January 2012.

[Ref_WMSP642-12] 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.

[pmid17976362-13] Skubitz KM, D'Adamo DR (November 2007). "Sarcoma". Mayo Clin. Proc. 82 (11): 1409–32. PMID 17976362. http://www.mayoclinicproceedings.com/content/82/11/1409.long.

[14] IAV. 26 February 2009.

[Ref_Klatt417-15] Klatt, Edward C. (2006). Robbins and Cotran Atlas of Pathology (1st ed.). Saunders. pp. 417. ISBN 978-1416002741.

[16] Dickson, B. 28 April 2011.

[pmid14161087-17] Dowling EA (June 1964). "Mesenchymal chondrosarcoma". J Bone Joint Surg Am 46: 747–54. PMID 14161087. http://www.ejbjs.org/cgi/reprint/46/4/747.pdf.

[pmid10809219-18] Fisher C (May 2000). "Parachordoma exists--but what is it?". Adv Anat Pathol 7 (3): 141–8. PMID 10809219.

[pmid14657948-19] 19.0 ^19.1 Aigner, T.; Oliveira, AM.; Nascimento, AG. (Feb 2004). "Extraskeletal myxoid chondrosarcomas do not show a chondrocytic phenotype.". Mod Pathol 17 (2): 214-21. doi:10.1038/modpathol.3800036. PMID 14657948.

[20] URL: http://www.cttr.org/cms/?p=736. Accessed on: 1 May 2011.

[21] Mitchell, AD.; Ayoub, K.; Mangham, DC.; Grimer, RJ.; Carter, SR.; Tillman, RM. (Jan 2000). "Experience in the treatment of dedifferentiated chondrosarcoma.". J Bone Joint Surg Br 82 (1): 55-61. PMID 10697315.

[pmid17653766-22] 22.0 ^22.1 Sopta, J.; Dordević, A.; Tulić, G.; Mijucić, V. (Feb 2008). "Dedifferentiated chondrosarcoma: our clinico-pathological experience and dilemmas in 25 cases.". J Cancer Res Clin Oncol 134 (2): 147-52. doi:10.1007/s00432-007-0262-5. PMID 17653766.

[Ref_WMSP643-23] Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 643. ISBN 978-0781765275.

[pmid12873205-24] 24.0 ^24.1 ^24.2 ^24.3 Parkin, B.; Bennett, JC.; Zaher, A. (Aug 2003). "Pathologic quiz case: an iliac mass in a 25-year-old woman. Osteochondroma.". Arch Pathol Lab Med 127 (8): e355-6. doi:10.1043/1543-2165(2003)127e355:PQCAIM2.0.CO;2. PMID 12873205.

[medpath-25] URL: http://www.medpath.info/MainContent/Skeletal/Bone_07.html. Accessed on: 18 September 2012.

[pmid22217414-26] Kokavec, M.; Gajdoš, M.; Džupa, V. (2011). "[Osteochondroma of the iliac crest: case report].". Acta Chir Orthop Traumatol Cech 78 (6): 583-5. PMID 22217414.

[upmc_case341-27] 27.0 ^27.1 URL: http://path.upmc.edu/cases/case341/dx.html. Accessed on: 19 September 2012.

[28] Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1247. ISBN 978-1416031215.

[pmid22827766-29] Kondo, R.; Akiba, J.; Hiraoka, K.; Hisaoka, M.; Hashimoto, H.; Kage, M.; Yano, H. (Aug 2012). "Malignant diffuse-type tenosynovial giant cell tumor of the buttock.". Pathol Int 62 (8): 559-64. doi:10.1111/j.1440-1827.2012.02838.x. PMID 22827766.

[pmid18301053-30] Li, CF.; Wang, JW.; Huang, WW.; Hou, CC.; Chou, SC.; Eng, HL.; Lin, CN.; Yu, SC. et al. (Apr 2008). "Malignant diffuse-type tenosynovial giant cell tumors: a series of 7 cases comparing with 24 benign lesions with review of the literature.". Am J Surg Pathol 32 (4): 587-99. doi:10.1097/PAS.0b013e318158428f. PMID 18301053.

[pmid10757395-31] 31.0 ^31.1 Somerhausen, NS.; Fletcher, CD. (Apr 2000). "Diffuse-type giant cell tumor: clinicopathologic and immunohistochemical analysis of 50 cases with extraarticular disease.". Am J Surg Pathol 24 (4): 479-92. PMID 10757395.

[32] URL: http://emedicine.medscape.com/article/1253223-overview. Accessed on: 6 January 2011.

[pmid10524485-33] Frassica, FJ.; Bhimani, MA.; McCarthy, EF.; Wenz, J. (Oct 1999). "Pigmented villonodular synovitis of the hip and knee.". Am Fam Physician 60 (5): 1404-10; discussion 1415. PMID 10524485.

[34] URL: http://www.wheelessonline.com/ortho/pigmented_villonodular_synovitis.

[pmid17031677-35] Krenn, V.; Morawietz, L.; König, A.; Haeupl, T. (Nov 2006). "[Differential diagnosis of chronic synovitis].". Pathologe 27 (6): 402-8. doi:10.1007/s00292-006-0866-6. PMID 17031677.

[pmid22849738-36] Lucas, DR. (Aug 2012). "Tenosynovial giant cell tumor: case report and review.". Arch Pathol Lab Med 136 (8): 901-6. doi:10.5858/arpa.2012-0165-CR. PMID 22849738.

[Ref_DCHH341-37] 37.0 ^37.1 ^37.2 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 341. ISBN 978-0470519035. Cite error: Invalid <ref> tag; name "Ref_DCHH341" defined multiple times with different content Cite error: Invalid <ref> tag; name "Ref_DCHH341" defined multiple times with different content

[Ref_WMSP612-38] 38.0 ^38.1 ^38.2 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 612. ISBN 978-0781765275.

[pmid19094761-39] Pan, YW.; Huang, XY.; You, JF.; Tian, GL.; Li, C. (Nov 2008). "[Malignant giant cell tumor of the tendon sheaths in the hand].". Zhonghua Wai Ke Za Zhi 46 (21): 1645-8. PMID 19094761.

[pmid8230758-40] 40.0 ^40.1 Shinjo, K.; Miyake, N.; Takahashi, Y. (Oct 1993). "Malignant giant cell tumor of the tendon sheath: an autopsy report and review of the literature.". Jpn J Clin Oncol 23 (5): 317-24. PMID 8230758.

[pmid22282671-41] Suresh, SS.; Zaki, H. (Dec 2010). "Giant cell tumor of tendon sheath: case series and review of literature.". J Hand Microsurg 2 (2): 67-71. doi:10.1007/s12593-010-0020-9. PMID 22282671.

[pmid16775919-42] Meydan N, Barutca S, Guney E, et al. (June 2006). "Brown tumors mimicking bone metastases". J Natl Med Assoc 98 (6): 950–3. PMC 2569361. PMID 16775919. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569361/?page=1.

[43] Shiau, Carolyn; Toren, Andrew (2006). Toronto Notes 2006: Comprehensive Medical Reference (Review for MCCQE 1 and USMLE Step 2) (22nd edition (2006) ed.). Toronto Notes for Medical Students, Inc.. pp. Emerg.. ISBN 978-0968592861.

[44] URL: http://path.upmc.edu/cases/case139/micro.html. Accessed on: 6 January 2012.

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

[18]

[19]

[20]

[21]

[22]

[23]

[24]

[25]

[26]

[27]

[28]

[29]

[30]

[31]

[32]

[33]

[34]

[35]

[36]

[37]

[38]

[39]

[40]

[41]

[42]

[43]

[44]

@@ Line 599: / Line 599: @@
 *Foam cells.
-DDx - general for site:<ref name=pmid17031677>{{Cite journal  | last1 = Krenn | first1 = V. | last2 = Morawietz | first2 = L. | last3 = König | first3 = A. | last4 = Haeupl | first4 = T. | title = [Differential diagnosis of chronic synovitis]. | journal = Pathologe | volume = 27 | issue = 6 | pages = 402-8 | month = Nov | year = 2006 | doi = 10.1007/s00292-006-0866-6 | PMID = 17031677 }}</ref>
+DDx - general for the site:<ref name=pmid17031677>{{Cite journal  | last1 = Krenn | first1 = V. | last2 = Morawietz | first2 = L. | last3 = König | first3 = A. | last4 = Haeupl | first4 = T. | title = [Differential diagnosis of chronic synovitis]. | journal = Pathologe | volume = 27 | issue = 6 | pages = 402-8 | month = Nov | year = 2006 | doi = 10.1007/s00292-006-0866-6 | PMID = 17031677 }}</ref>
 *[[Synovial chondromatosis]].
 *[[Gout]].

Difference between revisions of "Chondro-osseous tumours"

Revision as of 02:26, 29 November 2013

General

Common malignant

Malignant bone tumours by age

Benign aggressive bone tumours

Summary tables

Bone tumours

Cartilage tumours

Other

Radiology

Radiologic features

Location

Cartilage

Chondroma

General

Radiology

Microscopic

Images

Chondroblastoma

General

Gross

Microscopic

Images

IHC

Chondromyxoid fibroma

General

Gross

Microscopic

Chondrosarcoma

General

Subtypes

Microscopic

Images

Variants

Mesenchymal chondrosarcoma

Myxoid chondrosarcoma

Extraskeletal myxoid chondrosarcoma

Dedifferentiated chondrosarcoma

Grading

IHC

Bone

Osteoma

General

Microscopic

Osteoid osteoma

Osteoblastoma

Ewing sarcoma

Osteosarcoma

Giant cell tumour of bone

Other

Osteochondroma

General

Gross

Microscopic

Diffuse tenosynovial giant-cell tumour

General

Gross

Microscopic

Images

Molecular

Sign out

Micro

Giant cell tumour of tendon sheath

General

Gross

Microscopic

Images

Sign out

Micro

Alternate

Adamantinoma

Brown tumour

General

Hypercalcemia DDx

Microscopic

Images

See also

References

External links