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A rare case of giant soft tissue chondroma of the wrist: A cytopathological study with review of the literature.

Khandeparkar SG, Joshi A, Khande T, Kesari M - J Cytol (2014)

Bottom Line: On cytohistopathological examination, it turned out to be a rare giant STC.Diagnosis is based on both radiological and cytohistological evaluation, which is indispensable for determining the tumor type.The detailed clinical, radiological, cytomorphological, and immune-histopathological study was carried out, which has prompted us to report this case along with a review of the literature.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.

ABSTRACT
Giant soft tissue chondromas (STCs) of the wrist are seldom encountered in clinical practice. Precise diagnosis of benign STC may pose diagnostic difficulties on clinical and radiological findings alone. We encountered a slowly growing soft tissue neoplasm in the radial aspect of the wrist joint of the right hand in a 52-year-old male, masquerading as a calcified hematoma, as suggested by magnetic resonance imaging. On cytohistopathological examination, it turned out to be a rare giant STC. The variable cellularity, in conjunction with cellular immaturity and atypia, could mislead one to a malignant pathological interpretation. Diagnosis is based on both radiological and cytohistological evaluation, which is indispensable for determining the tumor type. The detailed clinical, radiological, cytomorphological, and immune-histopathological study was carried out, which has prompted us to report this case along with a review of the literature.

No MeSH data available.


Related in: MedlinePlus

MRI right wrist and hand: (a) Well-defined lobulated lesion measuring 5 × 4 × 3 cm in the radial aspect of the wrist, appearing T2 hyperintense, with a peripheral T2 hypointense rim, slightly hyperintense on T1 W1 with a central hypointense area, with no significant post contrast enhancement; (b) the lesion was closely abutting the scaphoid and trapezoid. Erosions were noted in the lunate. FNA: (c) predominantly chondromyxoid substance showing chondrocytes (c) inset showing chondrocytes with mild atypia. (H and E, ×400), (d) showing clusters ofchondrocytes with vesicular nucleus and moderate amount of basophilic nucleus (H and E, ×400)
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Figure 1: MRI right wrist and hand: (a) Well-defined lobulated lesion measuring 5 × 4 × 3 cm in the radial aspect of the wrist, appearing T2 hyperintense, with a peripheral T2 hypointense rim, slightly hyperintense on T1 W1 with a central hypointense area, with no significant post contrast enhancement; (b) the lesion was closely abutting the scaphoid and trapezoid. Erosions were noted in the lunate. FNA: (c) predominantly chondromyxoid substance showing chondrocytes (c) inset showing chondrocytes with mild atypia. (H and E, ×400), (d) showing clusters ofchondrocytes with vesicular nucleus and moderate amount of basophilic nucleus (H and E, ×400)

Mentions: The radiograph findings were unremarkable, except for few areas of calcification. Magnetic resonance imaging (MRI) of the right wrist and hand showed a well-defined, lobulated lesion measuring 5 × 4 × 3 cm in the radial aspect of the wrist, appearing T2 hyperintense, with a peripheral T2 hypointense rim, slightly hyperintense on T1 W1, with a central hypointense area, with no significant post-contrast enhancement [Figure 1a]. The lesion was closely abutting the scaphoid and trapezoid [Figure 1b]. Erosions were noted in the lunate. The MRI findings were suggestive of chronic infective arthritis with a differential diagnosis of myositis ossificans and chronic calcified hematoma.


A rare case of giant soft tissue chondroma of the wrist: A cytopathological study with review of the literature.

Khandeparkar SG, Joshi A, Khande T, Kesari M - J Cytol (2014)

MRI right wrist and hand: (a) Well-defined lobulated lesion measuring 5 × 4 × 3 cm in the radial aspect of the wrist, appearing T2 hyperintense, with a peripheral T2 hypointense rim, slightly hyperintense on T1 W1 with a central hypointense area, with no significant post contrast enhancement; (b) the lesion was closely abutting the scaphoid and trapezoid. Erosions were noted in the lunate. FNA: (c) predominantly chondromyxoid substance showing chondrocytes (c) inset showing chondrocytes with mild atypia. (H and E, ×400), (d) showing clusters ofchondrocytes with vesicular nucleus and moderate amount of basophilic nucleus (H and E, ×400)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4150341&req=5

Figure 1: MRI right wrist and hand: (a) Well-defined lobulated lesion measuring 5 × 4 × 3 cm in the radial aspect of the wrist, appearing T2 hyperintense, with a peripheral T2 hypointense rim, slightly hyperintense on T1 W1 with a central hypointense area, with no significant post contrast enhancement; (b) the lesion was closely abutting the scaphoid and trapezoid. Erosions were noted in the lunate. FNA: (c) predominantly chondromyxoid substance showing chondrocytes (c) inset showing chondrocytes with mild atypia. (H and E, ×400), (d) showing clusters ofchondrocytes with vesicular nucleus and moderate amount of basophilic nucleus (H and E, ×400)
Mentions: The radiograph findings were unremarkable, except for few areas of calcification. Magnetic resonance imaging (MRI) of the right wrist and hand showed a well-defined, lobulated lesion measuring 5 × 4 × 3 cm in the radial aspect of the wrist, appearing T2 hyperintense, with a peripheral T2 hypointense rim, slightly hyperintense on T1 W1, with a central hypointense area, with no significant post-contrast enhancement [Figure 1a]. The lesion was closely abutting the scaphoid and trapezoid [Figure 1b]. Erosions were noted in the lunate. The MRI findings were suggestive of chronic infective arthritis with a differential diagnosis of myositis ossificans and chronic calcified hematoma.

Bottom Line: On cytohistopathological examination, it turned out to be a rare giant STC.Diagnosis is based on both radiological and cytohistological evaluation, which is indispensable for determining the tumor type.The detailed clinical, radiological, cytomorphological, and immune-histopathological study was carried out, which has prompted us to report this case along with a review of the literature.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.

ABSTRACT
Giant soft tissue chondromas (STCs) of the wrist are seldom encountered in clinical practice. Precise diagnosis of benign STC may pose diagnostic difficulties on clinical and radiological findings alone. We encountered a slowly growing soft tissue neoplasm in the radial aspect of the wrist joint of the right hand in a 52-year-old male, masquerading as a calcified hematoma, as suggested by magnetic resonance imaging. On cytohistopathological examination, it turned out to be a rare giant STC. The variable cellularity, in conjunction with cellular immaturity and atypia, could mislead one to a malignant pathological interpretation. Diagnosis is based on both radiological and cytohistological evaluation, which is indispensable for determining the tumor type. The detailed clinical, radiological, cytomorphological, and immune-histopathological study was carried out, which has prompted us to report this case along with a review of the literature.

No MeSH data available.


Related in: MedlinePlus