HONDROBLASTOMA

From Big Medical Encyclopedia

HONDROBLASTOMA (Greek chond-l'os a cartilage + blastos a sprout, a germ + - oma; synonym: a high-quality hoggdroblastoma of a bone, obyzvest-vlyayushchayasya a giant-cell tumor, a giant-cell hondrobla-ostomy, Kodman's tumor) — rather rare benign tumor of a bone.

It is allocated as a nosological form of century 1942 of Jaffa (H. L. Jaffe) and L. Likhtepstayn under the name «giant-cell hondroblasto-ma».

According to various researchers, the hondroblastoma meets in 1 — 6% of cases of benign tumors of bones. According to Shayo-vich (F. Schajowicz, 1981), men are ill twice more often than women; St. 70% are made by patients aged up to 20 years. Localization of Hondas-roblastomy is very typical: almost always it develops in long, is more rare short tubular bones and is located preferential in a proximal epiphysis and metaphyses. There is a representation that the hondroblastoma can develop against the background of anomaly of development of an epiphyseal cartilage.

Center of defeat of usually rounded shape. On a section fabric of a tumor of gray or bluish color with the yellowish centers of calcification. Microscopically the tumor consists generally of cells of a rounded or polygonal shape with round or reniform kernels. Also the cells with two and three kernels having accurate outlines meet. Existence of huge multinucleate cells is considered a characteristic microscopic sign of Hondas-roblastomy. Tumor cells are usually divided by large or smaller amount of cartilaginous interstitial substance. In sites of big Skoplje -


Fig. 2. The roentgenogram of a part of a thorax and shoulder of the child from hondroblastomy area of a shoulder joint (a direct projection):

the tumor of the considerable sizes replacing proximal department of a humeral bone and which is accurately delimited from surrounding soft tissues.

the niya of cells at impregnation by silver is always possible to reveal rather plentiful argyrophil network. At gistokhy. a research in cells of a tumor granules of a glycogen come to light. In nek-ry sites of a tumoral node numerous blood vessels meet, sites of myxomatosis can come to light that gives to a hondroblastoma looking alike chondromyxoid fibroma (see). In intercellular cartilaginous tissue, and also on the periphery of a tumor emergence of the centers of secondary enchondral bone formation is possible.

The wedge, symptomatology has no specifics. Pain, a swelling, sometimes hypostasis of fabrics in a zone, adjacent to the center of defeat are noted.

The diagnosis is established on the basis by a wedge, pictures, data rentgenol. research and results of a biopsy. Rentgenol. the picture is quite characteristic. In spongy substance of a bone the site of destruction of a bone tissue decides on equal contours. The center is located a little eccentric in the field of an epiphysis, from an epiphyseal cartilage, and extends to compact substance of a bone. Sometimes the center of a hondroblastoma can be a little displaced in the direction of a metaphysis. Cortical substance at the level of a tumor is thinned p podryto, but, as a rule, the layer keeps it a continuity (fig. 1). Against the background of destruction come to light in the form of «specks» of inclusion of salts of calcium. Sometimes defect of a bone tissue pronizy-

the separate bone partitions giving it a type of a multichamber cyst howl. At the level of the site of defeat the bone is, as a rule, thickened, as if blown up. Periosteal stratifications are expressed poorly. At the considerable sizes of a tumor in the affected bone the conglomerate of cartilaginous tissue decides on zones of calcification, to-ry it is accurately delimited from the soft tissues (fig. 2) surrounding a tumor.

The differential diagnosis is carried out with a chondroma (see) and a chondrosarcoma (see) on the basis of results rentgenol. and morfol. researches.

Treatment of hl. obr. operational — ex-a kokhleation of a tumor with the subsequent filling of a cavity with bone shaving or a partial resection of a bone. When for one reason or another it is impossible to carry out operational treatment, resort to radiation therapy.

The forecast is more often favorable. Recurrent tumors are sometimes possible, its malignancy is extremely seldom observed.

See also Bone, tumors.

Bibliography: Vinogradova T. P. Tumors of bones, page 55, M., 1973; M. V. Hondroblastom's Wolves of a bone, Vestn. rentgenol. and radio-gramophones., No. 2, page 8, 1960; Pathoanatomical diagnosis of tumors of the person, under the editorship of N. A. Krayevsky, etc., page 407, M., 1982; Reynbergs. A. Radiodiagnosis of diseases костей^ and joints, book 2, page 401, M., 1964; III and y island and p F., etc. Histologic classification of bone tumors, page 36, Geneva, WHO, 1974; D a h 1 i n D. Page and. I v i n s J. C. Benign chondroblastoma, Cancer, v. 30, p. 401, 1972; JaffeH.L. Lichtenstein L. Benign chondroblastoma of bone, Amer. J. Path., v. 18, p. 969, 1942; Me L e o d R. A. a. Beabout J. W. The roentgenographic features of chondroblastoma. Amer. J. Roentgenol., v. 118, p. 464, 1973; SchajowizcF. Tumors and tumorlike lesions of bone and joints, p. 135, N. Y. a. o., 1981.

BB. H. Nightingales; And. II. Korolyuk (rents.).

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