胫骨皮质旁软骨肉瘤1例报道及文献复习

Juxtacortical chondrosarcoma: a case report and review of literature

目的 :了解皮质旁软骨肉瘤的临床病理特征、诊断及鉴别诊断要点。方法 :报道 1例胫骨皮质旁软骨肉瘤临床和病理改变 ,结合文献对该肿瘤的临床表现、病理形态学特征及诊断和鉴别诊断要点进行讨论。结果 :皮质旁软骨肉瘤大体呈结节状 ,切面分叶状、瓷白色半透明 ,有砂砾感。镜下肿瘤主要为分化良好的透明软骨成分 ,由纤细的纤维束分割 ,或由化生的骨小梁包裹 ,可见软骨内钙化和骨化 ,可见灶性区黏液变性 ,缺乏肿瘤性骨样基质 ,免疫组织化学标记显示肿瘤细胞Vim、S 10 0蛋白阳性 ,PCNA少数细胞阳性。结论 :皮质旁软骨肉瘤是罕见的恶性程度较低的软骨肉瘤。

Purpose To investigate clinical and pathological characteristics of juxtacortical chondrosarcoma and its differential diagnoses. Methods A case of juxtacortical chondrosarcoma was reported with clinical and pathological findings, and discussed in differential diagnosis with review of the literature. Results The tumor was grossly irregular nodular, gray white and translucent on cut surface. Microscopically, the tumor was mainly composed of well developed hyaline cartilage. The cartilaginous lobules were separated by thin fibrous bands, or partly encased by metaplastic bone. There was focal myxoid change and endochondral ossification. No tumor osteoid can be found. Immunohistochemically, the tumor cells were positive for vimentin and S 100 protein. A few tumor cells showed positive for PCNA. Conclusion Juxtacortical chondrosarcoma is a rare cartilaginous sarcoma with lower grade malignancy.