Chondroma pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Soujanya Thummathati, MBBS [2]
Overview
Enchondroma arises from rests of growth plate cartilage or chondrocytes that are normally involved in the production and maintainence of the cartilaginous matrix, which consists mainly of collagen and proteoglycans.[1][2] Juxta-cortical chondromas (also known as periosteal chondromas) arise from the periosteum of tubular bones.[3] On microscopic histopathological analysis, avascular lobules of hyaline cartilagenous matrix interspersed with chondrocytes, separated by normal marrow are characteristic findings of chondromas.[4][5] On gross pathology, small (usually less than 3 cm), translucent, grey blue, nodular lesions with occasional calcifications are characteristic findings of chondromas.[1] Genes involved in the pathogenesis of enchondroma and periosteal chondromas may include isocitrate dehydrogenase 1 (IDH1) and IDH2.[6]
Pathogenesis
- Enchondromas arise from rests of growth plate cartilage or chondrocytes that are normally involved in the production and maintainence of the cartilaginous matrix, which consists mainly of collagen and proteoglycans.[1][2]
- Juxta-cortical chondromas (also known as periosteal chondromas) arise from the periosteum of tubular bones.[3]
Genetics
Genes involved in the pathogenesis of enchondroma and periosteal chondromas may include isocitrate dehydrogenase 1 (IDH1) and IDH2.[6]
Gross Pathology
- On gross pathology, small (usually less than 3 cm), translucent, grey blue, nodular lesions with occasional calcifications are characteristic findings of chondromas.[1][7]
Microscopic Pathology
- On microscopic histopathological analysis, avascular, fibrous lobules of hyaline cartilagenous matrix, interspersed with chondrocytes and separated by normal marrow are characteristic findings of chondromas. In malignant chondrosarcomas, the fibrous capsule, is irregular, with extensions into the surrounding tissues and may be used in differentiating it from the benign chondroma.[4][5]
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![Intermediate magnification; The sections show spaced small cells in a pale matrix with a light-blue tinge. No nuclear atypia is appreciated. No mitotic activity is apparent. Degenerative changes are seen focally.[8]](/images/0/08/Enchondrom-_intermed_mag.jpg)
Intermediate magnification; The sections show spaced small cells in a pale matrix with a light-blue tinge. No nuclear atypia is appreciated. No mitotic activity is apparent. Degenerative changes are seen focally.[8]
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![Very high magnification; The sections show spaced small cells in a pale matrix with a light-blue tinge. No nuclear atypia is appreciated. No mitotic activity is apparent. Degenerative changes are seen focally.[8]](/images/4/45/Enchondrom-very-high-mag.jpg)
Very high magnification; The sections show spaced small cells in a pale matrix with a light-blue tinge. No nuclear atypia is appreciated. No mitotic activity is apparent. Degenerative changes are seen focally.[8]
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![Histological findings of periosteal chondroma. The tumor is composed of bland chondrocytes in an abundant hyaline cartilage matrix.[9]](/images/2/2c/Juxtacort-chondrom-h%26p.jpg)
Histological findings of periosteal chondroma. The tumor is composed of bland chondrocytes in an abundant hyaline cartilage matrix.[9]
![Intermediate magnification; The sections show spaced small cells in a pale matrix with a light-blue tinge. No nuclear atypia is appreciated. No mitotic activity is apparent. Degenerative changes are seen focally.[8]](/index.php/File:Enchondrom-_intermed_mag.jpg)
![Very high magnification; The sections show spaced small cells in a pale matrix with a light-blue tinge. No nuclear atypia is appreciated. No mitotic activity is apparent. Degenerative changes are seen focally.[8]](/index.php/File:Enchondrom-very-high-mag.jpg)
![Histological findings of periosteal chondroma. The tumor is composed of bland chondrocytes in an abundant hyaline cartilage matrix.[9]](/index.php/File:Juxtacort-chondrom-h%26p.jpg)
Associated conditions
Enchondromas may be single or multiple. Multiple enchondromas are associated with the following:
| Associated disease | Findings | Occurance |
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Maffucci syndrome |
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Sporadic |
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Ollier disease |
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Sporadic |
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Metachondromatosis |
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Genetic (Autosomal dominant) |
Video
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References
- ↑ 1.0 1.1 1.2 1.3 Enchondroma. Radiopedia. http://radiopaedia.org/articles/enchondroma Accessed on December 15, 2015
- ↑ 2.0 2.1 Chondrocytes. Wikipedia. https://en.wikipedia.org/wiki/Chondrocyte. Accessed on December 16, 2015.
- ↑ 3.0 3.1 Juxta-cortical chondroma. Radiopedia. http://radiopaedia.org/articles/juxta-cortical-chondroma Accessed on December 15, 2015
- ↑ 4.0 4.1 Shariat Torbaghan S, Ashouri M, Jalayer Naderi N, Baherini N (2011). "Histopathologic Differentiation between Enchondroma and Well-differentiated Chondrosarcoma: Evaluating the Efficacy of Diagnostic Histologic Structures". J Dent Res Dent Clin Dent Prospects. 5 (3): 98–101. doi:10.5681/joddd.2011.022. PMC 3442455. PMID 22991614.
- ↑ 5.0 5.1 Semenova LA, Bulycheva IV (2007). "[Chondromas (enchondroma, periosteal chondroma, enchondromatosis)]". Arkh Patol. 69 (5): 45–8. PMID 18074822.
- ↑ 6.0 6.1 Amary MF, Bacsi K, Maggiani F, Damato S, Halai D, Berisha F; et al. (2011). "IDH1 and IDH2 mutations are frequent events in central chondrosarcoma and central and periosteal chondromas but not in other mesenchymal tumours". J Pathol. 224 (3): 334–43. doi:10.1002/path.2913. PMID 21598255.
- ↑ Periosteal and soft tissue chondromas. American Academy Of Orthopedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00677 Accessed on December 16, 2015.
- ↑ 8.0 8.1 Chondroma. LibrePathology. http://librepathology.org/wiki/index.php/File:Enchondroma_-_very_high_mag.jpg Accessed on December 16, 2015
- ↑ Juxtacortical chondroma. Hindawi. http://www.hindawi.com/journals/crior/2014/763480/fig5/ Accessed on January 4, 2016.
