Söder S, Oliveira A M, Inwards C Y, Müller S, Aigner T
Department of Pathology, University of Leipzig, Leipzig, FRG.
Pathology. 2006 Feb;38(1):35-8. doi: 10.1080/00313020500455803.
Chondroblastoma and clear cell chondrosarcoma are uncommon skeletal neoplasms that have a strong tendency to involve the epiphysis of long bones. They also share some overlapping histological features. Thus, it can be difficult both radiographically and histologically to distinguish these neoplasms. So far there are no immunohistochemical markers available that have been shown to be helpful in differentiating these neoplasms.
In our study of a series of clear cell chondrosarcomas (n = 15) and chondroblastomas (n = 35), S100, vimentin, aggrecan and collagen type II were detected by immunohistochemistry.
We detected immunohistochemical evidence of type II collagen within both the extracellular matrix-rich (chondroid) and matrix-poor areas in all 15 cases of clear cell chondrosarcoma. In contrast, immunohistochemical analysis failed to show staining of collagen type II in any of the 35 chondroblastomas. Other markers, including S100 protein, vimentin and aggrecan proteoglycan were tested in parallel and found to be focally positive in both neoplasms.
Therefore, our data show that in cases when clear cell chondrosarcoma and chondroblastoma pose a diagnostic challenge, the presence of type II collagen in the extracellular tumour matrix significantly supports the diagnosis of clear cell chondrosarcoma and aids in distinguishing it from chondroblastoma.
软骨母细胞瘤和透明细胞软骨肉瘤是罕见的骨骼肿瘤,极易累及长骨骨骺。它们还具有一些重叠的组织学特征。因此,在影像学和组织学上区分这些肿瘤都可能存在困难。到目前为止,尚无已证实有助于鉴别这些肿瘤的免疫组化标志物。
在我们对一系列透明细胞软骨肉瘤(n = 15)和软骨母细胞瘤(n = 35)的研究中,采用免疫组化检测S100、波形蛋白、聚集蛋白聚糖和II型胶原。
在所有15例透明细胞软骨肉瘤中,我们在富含细胞外基质(软骨样)和基质较少的区域均检测到II型胶原的免疫组化证据。相比之下,免疫组化分析在35例软骨母细胞瘤中均未显示II型胶原染色。同时检测了其他标志物,包括S100蛋白、波形蛋白和聚集蛋白聚糖蛋白多糖,发现这两种肿瘤均呈局灶性阳性。
因此,我们的数据表明,在透明细胞软骨肉瘤和软骨母细胞瘤的诊断面临挑战的病例中,肿瘤细胞外基质中存在II型胶原显著支持透明细胞软骨肉瘤的诊断,并有助于将其与软骨母细胞瘤区分开来。