GPR: 2019 - Week 26

From MGH Learn Pathology

Clinical history

64 year old man with hip and knee pain, found on imaging to have a lesion in the proximal femur


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Chondrosarcoma
  • Can arise from any bone derived from endochondral ossification
  • Pelvis > long bones (i.e. femur, humerus) >> small bones of hands and feet
  • When in a long bone, usually involves the metaphysis or diaphysis
  • Filling of medullary cavity
  • Scalloping of endosteal surface
  • Glistening gray-blue neoplastic hyaline cartilage
 

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Enchondroma

  • Usually small, 1-5 cm
  • Composed of small (~0.5 cm) coalescing glistening white to gray nodules
  • Gray = hyaline cartilage
  • White = mineralized matrix
  • Located in the medullary cavity
  • Well demarcated from surrounding bone
 

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Chondrosarcoma arising from an enchondroma

 

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Chordoma

  • Primary malignant tumor of bone with notochordal differentiation
  • Usually arises within axial skeleton
  • Soft, tan-gray, lobulated, gelatinous to chondroid cut surface
  • Expansile mass, usually invades adjacent soft tissue
 

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Osteosarcoma

  • Most common primary malignant tumor of bone
  • Patients are young, usually 10-20 years old with a second peak in patients > 50 years
  • Intramedullary lesion
  • Tan-white and hard (abundant mineralized bone) to glistening and gray (non-mineralized cartilaginous components)
  • Often with hemorrhage and cystic change
 



This week's Gross Pathology Roundup was presented by [[| , ]] on Mon, Jun 24, 2019.