거대세포종과 유사한 역분화 부분을 가지는 연골육종 - 1예 보고 -
Dedifferentiated Chondrosarcoma with Giant Cell-rich Sarcomatous Component Resembling Giant Cell Tumor - A Case Report -
황필규, 김한수, 이상훈, 김종재, 김민아, 원재경,
소속 상세정보
황필규 ( Hwang Pil-Gyu )
서울대학교 의과대학 병리학교실
김한수 ( Kim Han-Soo )
서울대학교 의과대학 정형외과학교실
이상훈 ( Lee Sang-Hoon )
서울대학교 의과대학 정형외과학교실
김종재 ( Kim Jong-Jae )
서울대학교 의과대학 병리학교실
김민아 ( Kim Min-A )
서울대학교 의과대학 병리학교실
원재경 ( Won Jae-Kyung )
서울대학교 의과대학 병리학교실
KMID : 0357920040380050345
Abstract
Dedifferentiated chondrosarcoma is an uncommon bone tumor, defined as a tumor in which two components -a low-grade chondrosarcoma and a high-grade non-cartilaginous sarcoma-coexist with abrupt interface. We report a rare case of giant-cell rich dedifferentiated chondrosarcoma occurred in the right distal femur shaft of a 60 year-old female. The plain X-ray film showed an irregular radiolucent mass. The T2-weighted MRI revealed a heterogeneous high signal intensity. It was an irregular mass composed of bluish-white, translucent chondroid elements and yellowish solid components with extraosseous invasion. Microscopically, a low-grade chondrosarcoma and a giant-cell rich spindle cell sarcoma with areas resembling giant cell tumor were recognized with abrupt transition. Immunohistochemical staining revealed a S100 protein positivity in chondroid cells and a few spindle cells. CD68 was strongly positive in giant cells. Vimentin was positive in both components and smooth muscle actin was positive in some spindle cells. There was no cytokeratin, desmin and myogenin immunopositivity. It is important to be aware of this rare variant of dedifferentiated chondrosarcoma to avoid the misdiagnosis of more common bone tumors including giant cell tumors.
키워드
Chondrosarcoma;Giant Cells;Dedifferentiation;Immunohistochemistry
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