Chondroblastic osteosarcoma: Cytomorphologic characteristics and differential diagnosis on FNA

Christopher VandenBussche, Srividya Sathiyamoorthy, Paul E. Wakely, Syed Z Ali

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Chondroblastic osteosarcoma (COS) is a uniformly fatal bone malignancy if not diagnosed and treated appropriately in a timely manner. Fine-needle aspiration (FNA) of osseous lesions is routinely performed in major medical centers. Appropriate characterization of the tumor will significantly influence patient management and outcomes. METHODS: A retrospective review of the cytopathology archives of 2 large tertiary care centers for a 15-year period (2001-2015) revealed 17 cases of COS (9 primary, 6 recurrent, and 2 metastatic cases) in 16 patients. Clinical outcome and histopathologic follow-up were reviewed and correlated. RESULTS: There were 9 male and 7 female patients (male-to-female ratio of approximately 1:1), ranging in age from 12 to 70 years (mean age, 29.2 years). The classic locations for osteosarcoma were commonly involved, such as the long bones around the region of the knee in 4 cases and the proximal humerus in 1 case. However, other “nonclassic” sites also were noted to be commonly involved, including the distal tibia or fibula (4 cases), sacroiliac region (4 cases), mandible (3 cases), and skull (1 case). Cytomorphologic characteristics were high cellularity; predominantly discohesive, single cells; small tissue fragments; background osteoid and chondroid matrix; spindled cells and plasmacytoid cells with moderate to abundant basophilic vacuolated cytoplasm and occasional multiple cytoplasmic processes; round to oval nuclei with anisonucleosis; and small to prominent nucleoli. There were scattered binucleated and multinucleated osteoclast-like giant cells. Cases with high-grade morphology demonstrated marked pleomorphism and abundant mitoses. CONCLUSIONS: The differential diagnosis of COS includes chondroblastoma, chondrosarcoma, and chondroid chordoma. A definitive diagnosis can be made with clinical and radiological correlation. Cancer Cytopathol 2016;124:493–500.

Original languageEnglish (US)
Pages (from-to)493-500
Number of pages8
JournalCancer cytopathology
Volume124
Issue number7
DOIs
StatePublished - Jul 1 2016

Fingerprint

Osteosarcoma
Fine Needle Biopsy
Differential Diagnosis
Chondroblastoma
Chordoma
Bone and Bones
Neoplasms
Chondrosarcoma
Fibula
Humerus
Osteoclasts
Giant Cells
Tibia
Mandible
Mitosis
Tertiary Care Centers
Skull
Knee
Cytoplasm

Keywords

  • chondroblastic osteosarcoma
  • chondrosarcoma
  • fine-needle aspiration
  • osteoid
  • osteosarcoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Chondroblastic osteosarcoma : Cytomorphologic characteristics and differential diagnosis on FNA. / VandenBussche, Christopher; Sathiyamoorthy, Srividya; Wakely, Paul E.; Ali, Syed Z.

In: Cancer cytopathology, Vol. 124, No. 7, 01.07.2016, p. 493-500.

Research output: Contribution to journalArticle

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