Edel G, Ueda Y, Nakanishi J, Brinker K H, Roessner A, Blasius S, Vestring T, Müller-Miny H, Erlemann R, Wuisman P
Gerhard-Domagk-Institute of Pathology, University of Münster, Federal Republic of Germany.
Virchows Arch A Pathol Anat Histopathol. 1992;421(4):355-66. doi: 10.1007/BF01660984.
The clinical and morphological findings of 53 chondroblastomas in the files of the Bone Tumour Registry of Westphalia are presented. The mean age of all patients was 19.2 years. The male-to-female ratio was 1.5:1. Forty-two of the tumours (79.8%) were located in the long tubular bones and short tubular bones of the hands and were closely related to the growth plate. Six cases (11.3%) were found in the flat bones, 4 cases (7.5%) in the tarsal bones and 1 case (1.9%) in the craniofacial bones. The characteristic radiological feature of 44 investigated lesions was a mostly eccentric radiolucency with a geographic pattern of bone destruction and matrix calcifications. Periosteal reaction was evident in 9% of the cases. Most tumours demonstrate the typical morphological features of chondroblastoma, but 3 cases resembled a giant cell tumour. In 2 cases a haemangiopericytoma-like growth pattern was observed. Nine of the tumours had an aneurysmal bone cyst-like component. Vascular invasion was seen in 1 case. Immunohistochemically most cells in 30 of the cases and fetal chondroblasts in 3 cases were strongly positive with vimentin and S-100 protein. Collagen type II was positive in the chondroid matrix of the tumours and in fetal cartilage tissue; collagen type VI was present focally around individual tumour cells and was always seen in the chondroid matrix of the lesions and in fetal cartilage. These findings support the cartilaginous nature of these tumours. In paraffin sections, 46.6% of the cases revealed a distinct positive reaction of some tumour cells with the monoclonal cytokeratin antibody KL1 (molecular weight 55-57 kDa). Only 4 of them demonstrated a coexpression with the other monoclonal cytokeratin antibody CK (clone MNF 116, molecular weight 45-56.5 kDa). In paraffin sections all fetal chondroblasts were negative with both cytokeratin antibodies. Frozen sections of 3 tumours showed a strong positive reaction with both cytokeratin antibodies in many chondroblasts, indicating an "aberrant" cytokeratin expression. Osteoclast-like giant cells stained positive with leucocyte-common antigen (LCA) and with the macrophage-associated antibody KP1, but were negative with the other macrophage-associated antibody MAC 387. Recurrence rate was 10.7%. The clinical course of all tumours was benign.
本文呈现了威斯特伐利亚骨肿瘤登记处档案中53例软骨母细胞瘤的临床及形态学研究结果。所有患者的平均年龄为19.2岁。男女比例为1.5:1。其中42例肿瘤（79.8%）位于手部的长管状骨和短管状骨，且与生长板密切相关。6例（11.3%）位于扁骨，4例（7.5%）位于跗骨，1例（1.9%）位于颅面骨。44例受调查病变的特征性放射学表现为大多呈偏心性透亮区，伴有地图样骨质破坏及基质钙化。9%的病例可见骨膜反应。大多数肿瘤表现出软骨母细胞瘤的典型形态学特征，但有3例类似巨细胞瘤。2例观察到血管外皮细胞瘤样生长模式。9例肿瘤具有动脉瘤样骨囊肿样成分。1例可见血管侵犯。免疫组化显示，30例中的大多数细胞及3例胎儿软骨母细胞对波形蛋白和S - 100蛋白呈强阳性。II型胶原在肿瘤的软骨样基质及胎儿软骨组织中呈阳性；VI型胶原局灶性存在于单个肿瘤细胞周围，且总是见于病变的软骨样基质及胎儿软骨中。这些发现支持了这些肿瘤的软骨性质。在石蜡切片中，46.6%的病例显示部分肿瘤细胞对单克隆细胞角蛋白抗体KL1（分子量55 - 57 kDa）呈明显阳性反应。其中仅有4例显示与另一种单克隆细胞角蛋白抗体CK（克隆MNF 116，分子量45 - 56.5 kDa）共表达。在石蜡切片中，所有胎儿软骨母细胞对两种细胞角蛋白抗体均呈阴性。3例肿瘤的冰冻切片显示许多软骨母细胞对两种细胞角蛋白抗体均呈强阳性反应，提示存在“异常”的细胞角蛋白表达。破骨细胞样巨细胞对白血细胞共同抗原（LCA）及巨噬细胞相关抗体KP1呈阳性反应，但对另一种巨噬细胞相关抗体MAC 387呈阴性反应。复发率为10.7%。所有肿瘤的临床病程均为良性。
