McHugh Kelsey E, Emory Cynthia L, Parks Graham E, Kilpatrick Scott E
Department of Laboratory Medicine, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio, 44195.
Department of Orthopaedic Surgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, 27157.
Diagn Cytopathol. 2018 Feb;46(2):165-169. doi: 10.1002/dc.23808. Epub 2017 Sep 19.
Clear cell chondrosarcoma is a rare chondrosarcoma variant often involving the long bone epiphyses of young to middle aged adults. We report herein a case involving the left femoral head in a 25-year-old female with a 3-month history of worsening left hip pain. Radiographs revealed a complex, multifocal and lytic lesion centered in the left proximal femoral epiphysis with involvement of the femoral neck. Computed tomography-guided fine needle aspiration biopsy with concomitant core needle biopsy was performed, and a diagnosis of clear cell chondrosarcoma was rendered. Cytologic smears revealed aggregates of matrix material accompanied by a population of mostly uniform spindled to epithelioid and histiocytoid cells, rarely accompanied by osteoclast-type giant cells. The patient underwent surgical resection with -total hip replacement, and subsequent pathologic examination confirmed the initial needle biopsy diagnosis. There has been no evidence of local recurrence or distant metastases with 3-years follow-up. To our knowledge, this is the first reported example of a primary clear cell chondrosarcoma initially evaluated by fine needle aspiration biopsy.
透明细胞软骨肉瘤是一种罕见的软骨肉瘤变体,常累及年轻至中年成年人的长骨骨骺。我们在此报告一例25岁女性,其左股骨头受累,有3个月左髋部疼痛加重病史。X线片显示一个复杂、多灶性溶骨性病变,位于左股骨近端骨骺并累及股骨颈。进行了计算机断层扫描引导下的细针穿刺活检及同轴芯针活检,诊断为透明细胞软骨肉瘤。细胞学涂片显示基质材料聚集,伴有一群大多形态一致的梭形至上皮样及组织细胞样细胞,很少伴有破骨细胞型巨细胞。患者接受了全髋关节置换手术切除,随后的病理检查证实了最初针吸活检的诊断。随访3年无局部复发或远处转移的证据。据我们所知,这是首例经细针穿刺活检初步评估的原发性透明细胞软骨肉瘤病例。