Bone
Cartilaginous tumors other than chondrosarcoma
Chondroblastoma


Topic Completed: 1 August 2013

Revised: 10 July 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: Chondroblastoma

Nat Pernick, M.D.
Page views in 2018: 9,158
Page views in 2019 to date: 9,110
Cite this page: Pernick N. Chondroblastoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/bonechondroblastoma.html. Accessed October 20th, 2019.
Definition / general
  • Rare (< 1% of primary bone neoplasms), usually teenage males with open growth plate
  • Painful, often causes joint effusions and restricts joint mobility
  • Sites: distal femur, proximal humerus, proximal tibia, pelvis, ribs, feet, scapula; usually epiphysis (open) or apophysis such as iliac crest; may extend into metaphysis; also skull in older patients
  • Course: usually benign, but commonly recurs (often with atypia), rarely invades locally; rarely pulmonary metastases occur after surgical manipulation of primary tumor; patients survive after removal of localized metastases but not if multiple
Radiology description
  • Extremely well circumscribed tumor of epiphysis with spotty calcifications in patient with open epiphysis
Radiology images

AFIP images

Radiograph of tibia


Contributed by Dr. Mark R. Wick

Femur xray

Foot talus xray

Humerus xray

Proximal humerus xray

Treatment
  • Excision or curettage with bone grafting
Case reports
Gross description
  • Well circumscribed, white - blue - gray, firm
  • Usually 3 - 6 cm
  • Variable calcification, necrosis, cystic areas
Microscopic (histologic) description
  • Varies with time - early hypercellularity, followed by necrosis, followed by fibrous or chondroid areas with occasional spindle cells
  • Compact polyhedral chondroblasts with abundant pink cytoplasm and variable pigment, well defined cell borders and hyperlobulated nuclei with grooves in mineralized, chicken wire matrix that surrounds chondroblasts
  • Chondroid differentiation almost always present (pink vs. blue matrix)
  • May have marked cellularity, intracytoplasmic glycogen granules, mitotic figures, necrosis, osteoclast - type giant cells
  • 25% - 50% have secondary aneurysmal bone cyst
  • Hyaline cartilage is rarely seen
  • No significant nuclear atypia
Microscopic (histologic) images

AFIP images

Nuclei vary in size

Neoplastic cells with ovoid to spindled nuclei

Well formed chondroid matrix

"Chicken wire" appearance


Contributed by Dr. Mark R. Wick

Foot talus




Images hosted on other servers:

Quiz cases

Figures 1/2: expansile and lytic lesion of proximal digit and articular surface
3: giant cells
4: chondroid type matrix with chicken-wire, pericellular calcifications

Positive stains
Electron microscopy description
  • Resembles tissue culture epiphyseal cartilage cells with prominent fibrous lamina that causes microscopic well defined cell borders
Differential diagnosis
  • Chondromyxoid fibroma: metaphyseal, myxoid with pseudolobular pattern with pleomorphic stellate cells
  • Giant cell tumor: metaphyseal or epiphyseal in patients with closed epiphysis, clustered giant cells that are larger and more numerous than chondroblastoma, no chondroid differentiation, no chicken wire matrix
Additional references
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