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Presented by Dr. John Gross and prepared by Dr. Yembur Ahmad
This case talks about a 62 year-old female with a bony lesion.
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1. Question
This is a 62-year-old female with a bony lesion.
Diagnosis:
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The lesion is predominantly lytic with a ring and arc pattern of radiodensity on x-ray which is typical of chondroid differentiation. The border is sclerotic, indicating a low grade lesion. Histologically, the nuclei are lymphocyte-like or low grade, and there is no evidence of permeative growth. These are the typical features of an enchondroma.
Chrondrosarcoma would demonstrate greater atypia and more permeative growth in the marrow. Chrondoblastoma has neoplastic cells with grooved nuclei and a grungy chicken-wire calcified matrix. Chrondoblastic osteosarcoma would demonstrate greater cytologic atypia in the neoplastic cells which, at least focally, produce neoplastic bone justifying the diagnosis of osteosarcoma.Incorrect
The lesion is predominantly lytic with a ring and arc pattern of radiodensity on x-ray which is typical of chondroid differentiation. The border is sclerotic, indicating a low grade lesion. Histologically, the nuclei are lymphocyte-like or low grade, and there is no evidence of permeative growth. These are the typical features of an enchondroma.
Chrondrosarcoma would demonstrate greater atypia and more permeative growth in the marrow. Chrondoblastoma has neoplastic cells with grooved nuclei and a grungy chicken-wire calcified matrix. Chrondoblastic osteosarcoma would demonstrate greater cytologic atypia in the neoplastic cells which, at least focally, produce neoplastic bone justifying the diagnosis of osteosarcoma.
