Chondrosarcoma pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Shivali Marketkar, M.B.B.S. [2]

Pathophysiology

Microscopic Pathology

In general chondrosarcomas are multilobulated (due to hyaline cartilage nodules) with central high water content and peripheral enchondral ossification. Each chondrosarcoma subtype has specific characteristics:

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.

Islands of cartilage in a background of small blue cells

Myxoid chondrosarcoma

• Myxoid background.
• small cells with eosinophilic cytoplasm.

Anastomizing chords of small neoplastic cells surround mucin pools

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.

High grade round cells with cytoplasmic clearing

The lesion also had areas of more conventional chondrosarcoma

Dedifferentiated chondrosarcoma

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

Video

Below is a video of Extraskeletal Myxoid chondrosarcoma {{#ev:youtube|DxljkFd9xew}}

References

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