软骨肉瘤
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• In contrast to enchondroma, chondrosarcoma rarely involves the distal extremities
Introduction
• Categories of primary chondrosarcomas have been described, including： conventional intramedullary（普通髓内型）, juxtacortical（皮质旁型）, extraskeletal（骨外 型）, clear cell（透明细胞型）, myxoid（粘液 型）, mesenchymal（间质型）and
Metaphyseal intramedullary lesions: Osteosarcoma is usually centered in the metaphysis. Chondrosarcoma and fibrosarcoma often present as metaphyseal lesions. Osteoblastoma, enchondroma, fibrous dysplasia, simple bone cyst, and aneurysmal bone cyst are commonin this location.
• 3.5% of all primary bone tumors and 20%-27% of primary malignant osseous neoplasms, exceeded in frequency only by multiple myeloma and osteosarcoma.
diagnosis).
Diaphyseal lesions centered in the cortex: Adamantinoma, osteoid osteoma
Diaphyseal intramedullary lesions: Favored location for Ewing's sarcoma, lymphoma, myeloma. Common for fibrous dysplasia and enchondroma
chondrosarcoma
metastatic tumors myeloma leukemic involvement chondrosarcoma osteosarcoma (Paget's associated) MFH chordoma
Introduction
• Chondrosarcomas are malignant neoplasms populated by mesenchymal cells that produce a cartilaginous matrix.
Chondrosarcoma 软骨肉瘤
胸组病例讨论 09.11.10
Diaphysis
Metaphysis Epiphysis
Other
Myeloid
多发性骨髓瘤（Multiple myeloma）
Epithelial
釉质细胞瘤（Adamantinoma）
PNET
Ewing’s sarcoma
Osteoblast Chondroblast Fibrous Chondroblast
Hale Waihona Puke Baidu
Epiphyseal lesions: Chondroblastoma (Ch) and Giant Cell Tumor (GCT) are almost invariably centered in the epiphysis.
AGE (probably the most important clinical clue).
骨样骨瘤 成骨细胞瘤（Osteoblastoma） 骨瘤 （Osteoma） 骨肉瘤（Osteosarcoma）
软骨瘤 软骨肉瘤（Chondrosarcoma） 骨软骨 瘤 软骨粘液样纤维瘤
骨化纤维瘤（Ossifying fibroma） 纤维肉瘤 （Fibrosarcoma）
成软骨细胞瘤（Chondroblastoma）
Metaphyseal lesions centered in the cortex: Classic location for a non-ossifying fibroma (NOF). Also, a common site f osteoid osteoma.
Metaphyseal exostosis: Osteochondroma
• Most patients are in the 40-60 year range with a 2:1 male predilection
Introduction
• The bones of the shoulder, pelvis, proximal femur and ribs are most commonly involved
enchondroma giant cell tumor
40 & above osteoma
Ewing's sarcoma leukemic involvement metastatic neuroblastoma
osteosarcoma, Ewing's sarcoma, adamantinoma
Myeloid Notochord
骨巨细胞瘤（Giant cell tumor of bone） 脊索瘤(Chordoma)
SITE OF LONG BONE INVOLVEMENT
(most primary bone tumors have favored sites within long bones; this may provide a clue to
Age group Most common benign lesions Most common malignant tumors
0 - 10 10 - 20 20 - 40
simple bone cyst eosinophilic granuloma (嗜酸性肉 芽肿)
non-ossifying fibroma fibrous dysplasia simple bone cyst aneurysmal bone cyst osteochondroma (exostosis) osteoid osteoma osteoblastoma chondroblastoma chondromyxoid fibroma
Introduction
• Categories of primary chondrosarcomas have been described, including： conventional intramedullary（普通髓内型）, juxtacortical（皮质旁型）, extraskeletal（骨外 型）, clear cell（透明细胞型）, myxoid（粘液 型）, mesenchymal（间质型）and
Metaphyseal intramedullary lesions: Osteosarcoma is usually centered in the metaphysis. Chondrosarcoma and fibrosarcoma often present as metaphyseal lesions. Osteoblastoma, enchondroma, fibrous dysplasia, simple bone cyst, and aneurysmal bone cyst are commonin this location.
• 3.5% of all primary bone tumors and 20%-27% of primary malignant osseous neoplasms, exceeded in frequency only by multiple myeloma and osteosarcoma.
diagnosis).
Diaphyseal lesions centered in the cortex: Adamantinoma, osteoid osteoma
Diaphyseal intramedullary lesions: Favored location for Ewing's sarcoma, lymphoma, myeloma. Common for fibrous dysplasia and enchondroma
chondrosarcoma
metastatic tumors myeloma leukemic involvement chondrosarcoma osteosarcoma (Paget's associated) MFH chordoma
Introduction
• Chondrosarcomas are malignant neoplasms populated by mesenchymal cells that produce a cartilaginous matrix.
Chondrosarcoma 软骨肉瘤
胸组病例讨论 09.11.10
Diaphysis
Metaphysis Epiphysis
Other
Myeloid
多发性骨髓瘤（Multiple myeloma）
Epithelial
釉质细胞瘤（Adamantinoma）
PNET
Ewing’s sarcoma
Osteoblast Chondroblast Fibrous Chondroblast
Hale Waihona Puke Baidu
Epiphyseal lesions: Chondroblastoma (Ch) and Giant Cell Tumor (GCT) are almost invariably centered in the epiphysis.
AGE (probably the most important clinical clue).
骨样骨瘤 成骨细胞瘤（Osteoblastoma） 骨瘤 （Osteoma） 骨肉瘤（Osteosarcoma）
软骨瘤 软骨肉瘤（Chondrosarcoma） 骨软骨 瘤 软骨粘液样纤维瘤
骨化纤维瘤（Ossifying fibroma） 纤维肉瘤 （Fibrosarcoma）
成软骨细胞瘤（Chondroblastoma）
Metaphyseal lesions centered in the cortex: Classic location for a non-ossifying fibroma (NOF). Also, a common site f osteoid osteoma.
Metaphyseal exostosis: Osteochondroma
• Most patients are in the 40-60 year range with a 2:1 male predilection
Introduction
• The bones of the shoulder, pelvis, proximal femur and ribs are most commonly involved
enchondroma giant cell tumor
40 & above osteoma
Ewing's sarcoma leukemic involvement metastatic neuroblastoma
osteosarcoma, Ewing's sarcoma, adamantinoma
Myeloid Notochord
骨巨细胞瘤（Giant cell tumor of bone） 脊索瘤(Chordoma)
SITE OF LONG BONE INVOLVEMENT
(most primary bone tumors have favored sites within long bones; this may provide a clue to
Age group Most common benign lesions Most common malignant tumors
0 - 10 10 - 20 20 - 40
simple bone cyst eosinophilic granuloma (嗜酸性肉 芽肿)
non-ossifying fibroma fibrous dysplasia simple bone cyst aneurysmal bone cyst osteochondroma (exostosis) osteoid osteoma osteoblastoma chondroblastoma chondromyxoid fibroma