synovial chondromatosis and chondrosarcoma a diagnostic dilemma滑膜chondromatosis和软骨肉瘤诊断困境.pdfVIP

Sarcoma, June 2003, VOL. 7, NO. 2, 69–73 ORIGINAL ARTICLE Synovial chondromatosis and chondrosarcoma: a diagnostic dilemma 1 1 2 2 BRITA L. SPERLING , STEVEN ANGEL , GRANT STONEHAM , VANCE CHOW , ANDREW MCFADDEN3 RAJNI CHIBBAR1 Departments of 1Pathology, 2Radiology and 3 General Surgery, University of Royal, University Hospital, Saskatoon, Saskatchewan, Canada Abstract Purpose : The progression of synovial chondromatosis to chondrosarcoma is very rare. Distinction between these two entities may be difficult on histology alone, and should be based on clinical, radiographic and microscopic evidence. Immunohistochemical markers that would facilitate differentiation between synovial chondromatosis and chondrosarcoma are currently being investigated. Patients : We describe the cases of two patients who presented wit hsynovial chondromatosis and progression to synovial chondrosarcoma during periods of 7 and 11 years. Several biopsies and resected specimens demonstrated synovial chondromatosis before a diagnosis of chondrosarcoma was made. Method : We have examined five markers (Bcl2, Ki67, p27, p16, and p53) in all specimens from these cases, as well as known cases of chondromatosis and chondrosarcoma for control purposes. Results : We found increased expression of Bcl2 in benign chondromatosis compared to synovial or central chondrosarcomas. Discussion: Distinction between chondromatosis and its progression to low grade chondrosarcoma is difficult at histological level, and must involve incorporation of clinical and radiographical data. Althoug hpreliminary, our study suggests that reduced or absent expression of Bcl2 is associated wit hmalignant transformation of chondromatosis. Key words: synovial chondromatosis, synovial chondrosarcoma, patholog