Department of Anatomic Pathology, University of Pittsburgh, Pittsburgh, PA, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
Histopathology. 2020 Jan;76(2):308-317. doi: 10.1111/his.13972. Epub 2019 Nov 26.
Chondroblastomas (CB) are rare bone tumours that typically arise in the epiphysis/apophysis of long bones in skeletally immature patients. We explore the clinicopathological features of CB presenting in adults.
CB in patients ≥20 years of age were retrieved from our institutional archives. Thirty-nine CB were identified (29 male/10 female; aged 20-54 years). Twenty (51%) cases occurred in long tubular bones, 10 (26%) in small bones of the feet, five (13%) in flat bones and four (10%) in the patella. All cases showed classic cytological features of CB, and chondroid matrix was universally present. Calcification was identified in 10 cases (26%), including various combinations of serpiginous (n = 7), punctate (n = 6), classic chicken-wire (n = 4) and psammomatous (n = 2) patterns. Haemosiderin (n = 19), woven bone (n = 13), secondary aneurysmal bone cyst formation (n = 8), foamy macrophages (n = 4), hyalinised vascular spaces (n = 2) and cholesterol clefts (n = 2) were noted. Follow-up information (n = 32, 1-452 months) revealed local recurrence in three patients, all >40 years of age with flat bone origin, one of which developed pulmonary metastases 132 months after initial diagnosis.
CB in patients >20 years of age more frequently involves the short bones of the hands/feet and flat bones compared to those arising in their younger counterparts. A subset may harbour extensive serpiginous or psammomatous calcification rather than the classic chicken-wire pattern. Although the overall local recurrence rate in adulthood is approximately 10%, all three patients with recurrent disease had tumours involving flat bones, suggesting that tumours arising in these sites may behave more aggressively.
成软骨细胞瘤（CB）是一种罕见的骨肿瘤，通常发生在骨骼未成熟患者的长骨骨骺/附突处。我们探讨了发生于成年人的 CB 的临床病理特征。
从我们的机构档案中检索出年龄≥ 20 岁的 CB 患者。共确定了 39 例 CB（29 例男性/10 例女性；年龄 20-54 岁）。20 例（51%）发生于长管状骨，10 例（26%）发生于足部小骨，5 例（13%）发生于扁骨，4 例（10%）发生于髌骨。所有病例均表现出 CB 的典型细胞学特征，普遍存在软骨样基质。10 例（26%）可见钙化，包括各种形式的虫蚀样（n = 7）、点状（n = 6）、经典的铁丝网样（n = 4）和砂粒样（n = 2）模式。含铁血黄素（n = 19）、编织骨（n = 13）、继发性动脉瘤样骨囊肿形成（n = 8）、泡沫状巨噬细胞（n = 4）、玻璃样血管腔（n = 2）和胆固醇裂隙（n = 2）也被观察到。随访信息（n = 32，1-452 个月）显示 3 例患者局部复发，均为年龄>40 岁，起源于扁骨，其中 1 例在初始诊断后 132 个月发生肺转移。
年龄>20 岁的患者的 CB 更频繁地涉及手部/足部的短骨和扁骨，而不是那些在年轻患者中发生的 CB。亚组可能具有广泛的虫蚀样或砂粒样钙化，而不是经典的铁丝网样模式。尽管成年人的总体局部复发率约为 10%，但所有 3 例复发病例的肿瘤均累及扁骨，表明这些部位发生的肿瘤可能具有更具侵袭性的行为。
