Fanning C V, Sneige N S, Carrasco C H, Ayala A G, Murray J A, Raymond A K
Department of Pathology, University of Texas M. D. Anderson Cancer Center, Houston.
Cancer. 1990 Apr 15;65(8):1847-63. doi: 10.1002/1097-0142(19900415)65:8<1847::aid-cncr2820650831>3.0.co;2-q.
Between 1979 and 1987 12 patients with chondroblastoma underwent fine needle aspiration (FNA). There were eight female and four male patients (age range, 11-35 years) with lesions of the proximal humerus (three cases), distal femur (two cases), proximal tibia (two cases), proximal femur, distal tibia, talus, navicular bone, and fifth metacarpal (one case each). The radiologic features of the tumors were not entirely typical of chondroblastoma in the majority of patients. The aspirate was diagnosed as chondroblastoma in seven cases, was considered strongly suggestive of chondroblastoma in one case, was found to be diagnosable as chondroblastoma on review in one case, and was nondiagnostic in two cases. The remaining case, which showed giant cell tumor-like areas in addition to typical chondroblastoma on histologic sections from the curettage, was interpreted as giant cell tumor on FNA. There was no case in which an aspirate was erroneously diagnosed as chondroblastoma. On FNA, chondroblastoma had three dominant cytologic components: neoplastic mononuclear cells (chondroblasts), multinucleated osteoclast-like giant cells, and chondroid matrix fragments. The chondroblasts tended to lie individually in smears creating a pebbled appearance. They most commonly had round to oval nuclei with fine, evenly distributed chromatin and distinct longitudinal grooves, but indented, lobulated, and pyknotic nuclei were also observed. Their cytoplasm was dense and opaque with rounded well-defined borders. Multinucleated osteoclast-like giant cells were randomly admixed and were indistinguishable from those seen in other bone neoplasms. Chondroid matrix stained magenta with the Diff-Quik stain and green to violet with Papanicolaou. The cytologic features of the chondroblasts are the diagnostic hallmark of chondroblastoma and may allow FNA to become a valuable preoperative technique in the management of these patients.
1979年至1987年间，12例软骨母细胞瘤患者接受了细针穿刺抽吸（FNA）检查。患者中8例为女性，4例为男性（年龄范围为11至35岁），病变部位包括肱骨近端（3例）、股骨远端（2例）、胫骨近端（2例）、股骨近端、胫骨远端、距骨、舟状骨和第五掌骨（各1例）。大多数患者肿瘤的放射学特征并不完全符合软骨母细胞瘤的典型表现。7例抽吸物诊断为软骨母细胞瘤，1例高度提示软骨母细胞瘤，1例复查时诊断为软骨母细胞瘤，2例诊断不明确。其余1例，刮除术组织学切片除典型软骨母细胞瘤外还显示巨细胞瘤样区域，FNA时被误诊为巨细胞瘤。没有抽吸物被错误诊断为软骨母细胞瘤的病例。FNA检查时，软骨母细胞瘤有三种主要的细胞学成分：肿瘤性单核细胞（成软骨细胞）、多核破骨细胞样巨细胞和软骨样基质碎片。成软骨细胞在涂片上往往单个分布，形成鹅卵石样外观。它们最常见的是圆形至椭圆形核，染色质细、分布均匀且有明显的纵向沟，但也可见凹陷、分叶和固缩核。其细胞质致密、不透明，边界清晰呈圆形。多核破骨细胞样巨细胞随机混合，与其他骨肿瘤中的巨细胞无法区分。软骨样基质用Diff - Quik染色呈品红色，用巴氏染色呈绿色至紫色。成软骨细胞的细胞学特征是软骨母细胞瘤的诊断标志，可能使FNA成为这些患者有价值的术前检查技术。
