Question
A 50-year-old lady presented with a 3-month history of pain in the lower third of the right thigh. There was no local swelling; tenderness was present on deep pressure. Plain X-rays showed as represented in the picture below.
Sections showed a cartilaginous tumor. Which of the following histological features (if seen) would be most helpful to differentiate this tumor from chondrosarcoma ?
A. Focal necrosis and lobulation.
B. Tumor permeation between bone trabecuae at periphery.
C. Extensive myxoid change.
D. High cellularity.
Show Answer
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Correct Answer » B
Explanation
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The bone tumor as shown in the picture above represents Enchondroma (Appearance: Mottled calcifications, Rarefactions at epiphysis).
Tumour permeation between bony trabeculae at periphery is the histological features (if seen) would be most helpful to differentiate this tumor from chondrosarcoma.
Chondroma (enchondroma) Vs Chondrosarcoma
The term chondroma is used for benign neoplasm composed of cartilage. It is of two types : –
- Enchondroma : – Cartilage tumors occuring within the bone.
- Periosteal chondroma : – Cartilage tumors occuring on the surface of the bone.
- Chondrosarcoma is the malignant tumor of cartilage.
- Growth potential of chondroma is limited and mostly remain stable, but they have a potential to undergo malignant (sarcomatous) change to become chondrosarcoma. lnfact, enchondromas are considered to be a low grade chondrosarcoma.
- A painful chondroid neoplasm in a large bone in an adult patient can be either enchondroma or chondrosarcoma
- The differentiation between a low grade chondrosarcoma and an enchondroma can be difficult.
- To make distinction between these two neoplasms, one has to make use of
Cytological changes
Myxoid quality of stroma
Permeative characteristics
Among these permeation, maifested as marrow spaces filled with the neoplasm and entrapment of preexisting bony trabeuculae is the most important sign of malignancy.
