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Chordoma.pptx
1. 22 Y/M with Sacral Mass
Dr. Om Jha
Pathology Resident
Shree Birendra Hospital; NAIHS
2. Case History:
• 22 year/ male
• Presentation: Painless
swelling in the lower
back x 5years
• 0/E: Firm mass, 2x 2cm,
non-tender, in sacral
region without
overlying skin changes.
3. Radiology (USG):
• Cystic lesion measuring
13.8 x 6mm at region of
lower sacral region
• Lesion shows low
echogenic content,
likely fat.
4. Gross:
• On multiple attempts, scant grey-white
material aspirated from the lesion.
• 1 PAP and 2 Giemsa stained slides.
10. Notochordal vestige:
Favouring Points:
• Location
• Cytomorphology:
Physaliphorous cells with less
prominent vacuolation
• Cells within myxoid
background
• Lacks atypia.
• Radio: no bony destruction.
Non-favouring Points:
• Sheets or nests of
physaliferous cells.
• Tumor Size: < 1cm
• Fibrillary chondroid
background.
11. Notochordal vestige:
Favouring Points:
• Location
• Myxoid background
• Cells have eosinophilic
cytoplasm with small vacuoles,
pyknotic round nuclei
• Lacks atypia.
• Radio: no bony destruction.
Non-favouring Points:
• Sheets or nests of
physaliferous cells.
• Size: <1 cm.
• Fibrillary chondroid
background
• Age: 1-3 years
12. Ref: The Surgical Pathology of Notochordal Remnants
in Adult Intervertebral Disks: A Report
Fig: Scattered degenerative notochordal cells with bland nuclei and
eosinophilic cytoplasm were present in the remnant
Article Case
13. Article: The Surgical Pathology of Notochordal
Remnants in Adult Intervertebral Disks
14. Extraosseous Benign Notochordal Cell
Tumor
Favouring Point:
• Age
• Adipocyte-like vacuolated
or eosinophilic cells with
fewer vacuoles.
• May contain colloid-like
material
• Bone trabeculae often
sclerotic but no bony
destruction
• No necrosis, no mitotic
figures
Non-favouring Point:
• Often cytoplasmic
eosinophilic hyaline
globules
• Bland round nuclei with
mild pleomorphism
• No intercellular myxoid
matrix
15. Left Fig: a sheet‐like proliferation of polygonal or round cells with
abundant, uni‐ or multi‐vacuolated cytoplasm.
BNCT Case
16. Incipient Chordoma:
Favoring Point:
• Age
• Site
• Granular and fibrillary
myxoid matrix
• Physaliphorous cells
• Radio: cortical involvement
Non-favouring Point:
• Cohesive clusters and cords
of neoplastic cells
• Atypia
• Necrosis
17. Chondroid syringoma
Ref: Pal S, Sengupta S, Jana S, Bose K. Fine-needle aspiration cytology of chondroid syringoma of fore arm: Report of a
rare case. J Cytol. 2014 Jul;31(3):171-3. doi: 10.4103/0970-9371.145659. PMID: 25538390; PMCID: PMC4274532.
• Dissociated and small
clusters of round
epithelial cells
• Well-defined
cytoplasmic margin
• Round nuclei with fine
chromatin
• Prominent nucleoli
• Fibrillary
chondromyxoid
material
• Fig: tight clusters of benign round to oval
epithelial cells and myoepithelial cells in
fibrillary chondro-myxoid ground substance
Editor's Notes
At low power, these cells may be confused
with fat [6,10,14]. At high magnification, the characteristic
physaliferous cells have a clear cytoplasm and eccentrically
located oval or round nuclei. Also seen are less vacuolated
cells with central, rounded nuclei and eosinophilic cytoplasm.
Nuclear atypia is minimal; pleomorphism, mitoses,
and necrosis are not seen [6,17]. Microcystic spaces with
colloid-like material have been observed in some lesions
At high magnification, the characteristic physaliferous cells have a clear cytoplasm and eccentrically located oval or round nuclei. Also seen are less vacuolated cells with central, rounded nuclei and eosinophilic cytoplasm. Nuclear atypia is minimal; pleomorphism, mitoses, and necrosis are not seen [6, 17]. Microcystic spaces with colloid-like material have been observed in some lesions
At high magnification, the characteristic physaliferous cells have a clear cytoplasm and eccentrically located oval or round nuclei. Also seen are less vacuolated cells with central, rounded nuclei and eosinophilic cytoplasm. Nuclear atypia is minimal; pleomorphism, mitoses, and necrosis are not seen [6, 17]. Microcystic spaces with colloid-like material have been observed in some lesions
