Chondrosarcoma - clear cell

Clear cell chondrosarcoma of the L4 vertebra inThe patient went on to have a 34 year old woman.

Final Diagnosis:

Complexcomplex resection of L4 vertebral body including left side posterior elements and associated soft tissues, adjacent intervertebral discs, the inferior body of L3 and superior body of L5:. 

1. Clear cell chondrosarcoma
2. Low grade, grade 1/3
3. Maximum size 3.6 cm
4. Based in the body and left pedicle of L4, with erosion of the posterior cortex, but confined by posterior longitudinal ligament with no extension to soft tissue. Focal erosion of anterior cortex in two foci, with microscopic invasion of anterior longitudinal ligament
5. Positive for vascular invasion adjacent to tumor
6. Negative for dedifferentiation
7. Two examined lymph nodes negative for malignancy

Histology

Microscopic Description:

Sections show a clear cell neoplasm arranged as sheets and as lacunae within a cartilaginous matrix. Some woven bone is produced, osteoclasts are present and the lesion is more vascular than a conventional chondrosarcoma. Cells have abundant clear and faintly eosinophilic cytoplasm which is PAS positive in a strong, granular pattern. Nuclei are centrally-located and show low grade-grade atypia, with occasional mitoses identified. Immunostains demonstrate the lesional cells to be intensely positive for S100, but negative for keratins, EMA, synaptophysin and chromogranin.

See belowThe L4 vertebral body appears somewhat lucent and the left pedicle is difficult to appreciate on frontal projection.